London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 721 713 Acute cerebrovascular events (ACE): TIA and minor strokes Transient neurological deficit as a rare presentation of spontaneous ICH C. Rossi1, D. Strbian2, T. Tatlisumak3, C. Cordonnier4 University Lille Nord de France, Department of Neurology and Stroke Unit, Lille, FRANCE1, Department of Neurology, Helsinki University Central Hospital, Helsinki, FINLAND2, Department of Neurology, Helsinki University Central Hospital, Helsinki, FINLAND3, University Lille Nord de France, Department of Neurology and Stroke Unit, Lille, FRANCE4 Backgrounds: Clinicians are well aware of the clinical severity and poor prognosis of patients with a spontaneous intracerebral haemorrhage (ICH). However, minor deficits or transient symptoms may be an uncommon presentation, rarely described. We aimed at identifying the clinical and radiolog-ical features of patients admitted for an ICH revealed by a transient neurological deficit. Methods: The PITCH Prognosis of Intracerebral Haemorrhage (Lille) and Helsinki cohorts are prospective, hospital-based cohorts of consecutive adults admitted with a spontaneous ICH. We performed bivar-iate analyses on clinical and radiological variables comparing patients with NIHSS 0 at admission versus those with NIHSS≥1. Results: Among 1490 consecutive adults, 41 patients (2.7%) had a NI-HSS= 0 at admission. The median age was 63 years interquartile range (IQR) 54 -75 vs. 70 years (IQR 59 -79) in patients with NIHSS ≥1 (p=0.01). NIHSS=0 patients had less frequently arterial hypertension (p=0.049) and atrial fibrillation (p=0.046), while other vascular risk factors were sim-ilar in the two groups. 71% of the patients (n=29) with NIHSS=0 had a cortical ICH. The median ICH volume was 4.6 cm3 (IQR 1.03 - 7.45). After 1 year of follow-up, 39 (95%) patients were alive, while 1 patient died from a recurrent ischemic stroke and 1 was lost to follow-up. Conclusion: Clini-cians should be aware that ICH might be revealed by a transient neurological deficit in about 3% of ICH cohorts. Even if this represents a rare occurrence, a rapid assessment with neuroimaging min-imizes potential misdiagnosis and mismanagement of these patients. The frequent cortical location might suggest a link with the underlying vascular disease (cerebral amyloid angiopathy). 714 Acute cerebrovascular events (ACE): TIA and minor strokes PREVALENCE AND PREDICTORS OF PAROXYSMAL ATRIAL FIBRILLATION IN PA-TIENTS WITH TRANSIENT ISCHEMIC ATTACK OF UNDETERMINED AETIOLOGY ATTENDED IN A TIA-CLINIC B.E. Sanz-Cuesta1, P. Martínez-Sánchez2, J. Fernández-Travieso3, B. Fuentes4, D. Filgueiras-Ra-ma5, G. Ruiz-Ares6, M. Lara-Lara7, L. Cuéllar-Gamboa8, S. Calcedo-Tamayo9, E. Díez-Tejedor10 Department of Neurology and Stroke Center. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN1, Department of Neurology and Stroke Center. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Uni-versidad Autónoma de Madrid., Madrid, SPAIN2, Department of Neurology and Stroke Center. Idi- PAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN3, Department of Cardiology. Arrhythmia Unit. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN4, Department of Neurology and Stroke Center. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Uni-versidad Autónoma de Madrid., Madrid, SPAIN5, Department of Neurology and Stroke Center. Idi- PAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN6, Department of Neurology and Stroke Center. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN7, Department of Neurology and Stroke Center. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Uni-versidad Autónoma de Madrid., Madrid, SPAIN8, Department of Neurology and Stroke Center. Idi- PAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN9,Department of Neurology and Stroke Center. IdiPAZ Health Research Institute. Hospital Universitario La Paz. Universidad Autónoma de Madrid., Madrid, SPAIN10 BACKGROUND: The knowledge about the prevalence of first diagnosed paroxysmal atrial fibrilla-tion (PAF) in patients with transient ischemic attack of undetermined aetiology (TIA-U) attended in a TIA-Clinic (TIAC) is scarce. Our purpose was to analyze it. METHODS: Observational transversal study of TIA-U with patients attended in a TIAC from Jan-uary 2010 to May 2012. Clinical data were prospectively collected in a specific data bank. A retro-spective analysis was performed including the following variables: demographic data, vascular risk factors, TIA/stroke risk scores, neuroimaging, neurosonology and echocardiography. All patients underwent a first 24-hour cardiac holter monitoring (24HM) and 26 patients a second one because PAF was suspected. The 24HM parameters were also recorded, including the presence of supraven-tricular tachycardia (SVT). Irregular SVT was defined by more than 30 msec of maximal difference between R-R in the longer paroxysm. RESULTS: Overall, 155 TIA patients were included, mean age 71 years (SD, 11.8), 50.3% were male. A total of 29 (18.3%) PAF were registered: 28 detected in the first 24HM and 1 in the second. The multivariate analysis showed that irregular SVT (OR 9.821, 95% CI 6.322-29.939 p<0.001) was the only factor associated with PAF diagnosis after adjustment by confounder factors. CONCLUSION: The diagnosis of PAF after a TIA-U is higher than expected. The presence of irreg-ular SVT in 24HM is strongly associated with the presence of PAF.
Karger_ESC London_2013
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