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London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 729 728 Acute cerebrovascular events (ACE): TIA and minor strokes Short - and Long – Term Effects of t-PA in Minor Stroke K. Villringer1, L.-A. Schaafs2, U. Grittner3, C.H. Nolte4, H. Audebert5, J.B. Fiebach6 Academic Neuroradiology, Center for Stroke Research, Charité, Berlin, GERMANY1, Aca-demic Neuroradiology, Center for Stroke Research, Charité, Berlin, GERMANY2, Center for Stroke Research, Institute for Biostatistics and Clinical Epidemiology, Charité, Berlin, GERMANY3, De-partment of Neurology and Center for Stroke Research, Charité, Berlin, GERMANY4, Department of Neurology and Center for Stroke Research, Charité, Berlin, GERMANY5, Academic Neurora-diology, Center for Stroke Research, Charité, Berlin, GERMANY6 Background: There is a continuing debate about whether patients with minor stroke symptoms benefit from thrombolysis. Therefore we tried to assess the association of t-PA and possible other co-variables on outcome in minor stroke cases. Methods: We prospectively analysed 134 patients with NIHSS 4 – 7 (n = 62) and greater than 7 (n = 48) either with or without thrombolysis with visible lesions on diffusion weighted images, examined in a 3 T MRI scanner. Results: There was a significant difference for NIHSS on day 6 for mild stroke patients having received t-PA (p = 0.05) contrary to those without thrombolysis, suggesting favourable short-term outcome due to t-PA. However, no significant difference was noticed for mRS in a 3 month follow-up in minor stroke with or without t-PA. Conclusion: There was significantly improved short-term outcome in minor stroke patients after t-PA therapy. However no long-term beneficial effect was noticed. Factors other than thrombolysis might account for this result. 729 Acute cerebrovascular events (ACE): TIA and minor strokes Meningeal disease masquerading as transient ischaemic attack L. CUINAT1, N. NASR2, A. JAFFRE3, F. BONNEVILLE4, V. LARRUE5 Department of Vascular Neurology. Toulouse University Hospital. INSERM 1048, TOU-LOUSE, FRANCE1, Department of Vascular Neurology. University of Toulouse. INSERM 1048, TOULOUSE, FRANCE2, Department of Vascular Neurology. Toulouse University Hospital. IN-SERM 1048, TOULOUSE, FRANCE3, Department of Neuroradiology. University of Toulouse. IN-SERM U825, TOULOUSE, FRANCE4, Department of Vascular Neurology. University of Toulouse. INSERM 1048, TOULOUSE, FRANCE5 Background. Cortical subarachnoid haemorrhage and meningitis sometimes present as episodes of transient neu-rological dysfunction mimicking transient ischaemic attack (TIA). In the present study, we sought to determine the frequency of meningeal disease among patients treated in a TIA clinic. Methods. Retrospective analysis of data from patients consecutively admitted to a TIA clinic between August 2010 and March 2012. Patients were classified as probable or possible ischaemic event (TIA or mi-nor stroke), or non-ischaemic event using clinical data and findings on brain imaging and ultrasound studies. Results. Of 529 patients (mean age 63.5 years), 134 (25.3%) were classified as non-ischaemic event. Men-ingeal disease was the likely cause of clinical symptoms in 9 (1.7%) patients including 5 patients with meningitis (1 tuberculous meningitis, 1 rheumatoid meningitis, 1 myelomatous meningitis, 1 lymphomatous meningitis, 1 HSV-1 meningoencephalitis), and 4 patients with cortical subarachnoid haemorrhage (probably related to cerebral amyloid angiopathy in 3 patients). Clinical symptoms comprised motor deficit (4), sensory deficit (4), aphasia (3), and dysarthria (2). Transient neurologi-cal dysfunction was recurrent in 7/9 patients. Duration of transient episodes ranged from 5 min to 30 min. No patient suffered headache. Nuqual rigidity was absent in all cases. MRI showed evidence of meningeal or meningocerebral disease in 9/9 patients. Meningeal disease (6.7%) ranked fifth as a cause of non-ischaemic event behind migraine with aura (22.3%), peripheral vestibular syndrome (14.1%), epilepsy (12.6%), and somatoform disorders (9.7%). Conclusion. Our study confirmed that serious meningeal disease could present as TIA, but this disease was rel-atively uncommon among patients treated in a TIA clinic. Results highlight the diagnostic value of MRI in these patients.


Karger_ESC London_2013
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