BACKGROUND: Transient ischemic attack is no longer considered a benign event but, rather a critical harbinger of impending stroke. Failure to quickly recognize and evaluate this warning sign could mean missing an opportunity to prevent permanent disability or death. There is no reliable way to determine if the abrupt onset of neurologic deficits represents reversible ischemia without subsequent brain damage or if ischemia will result in permanent damage to the brain. Rapid advances in computed tomography (CT) and magnetic resonance imaging (MRI) technology in the last 25 years have contributed significantly to our understanding of the pathophysiology of clinically defined TIAs. OBJECTIVES: This study aims to (1) determine the cranial CT scan findings among TIA patients admitted at Iloilo Mission Hospital for the period of November 2003-November 2005; (2) determine the common clinical features of patients admitted for TIA; (3) determine the most common risk factors in patients with TIA; (4) to determine the proportion of TIA patients admitted who underwent cranial CT scan. METHODS: This is a retrospective study of patients admitted with the diagnosis of TIA from November 2003-November 2005. The clinical history and physical examination as well as cranial CT scan findings were noted. Other pertinent data collected included age, gender, and co-morbid factors. RESULTS: Thirty-seven patients were included in the study, 72.9 percent of whom were above 60 years old. There were 12 (32.4 percent) men and 25 (67.6 percent) women (M:F-1:2.1). Known risk factors that were seen in this series included hypertension (HTN) + hypercholesterolemia (35.1 percent), HPN (29.7 percent), HPN + hypercholesterolemia + diabetes mellitus (24.3 percent), hypercholesterolemia alone (5.4 percent); no risk factors (5.4 percent). The most common presenting symptoms were slurred speech, dizziness, and hemiparesis. The duration of symptoms noted in patients with TIA were: 6 hours or less in 54.1 percent, followed by 7-12 hours in 16.2 percent, 13-18 hours in 13.5 percent, and 19-24 hours in 16.2 percent. Cranial CT scansd showed abnormalities in 94.1 percent of TIA patients. There were cerebral and basal ganglia infarctions (32.4 percent) taken with the duration of 6 hours (52.9 percent). Other findings include: cerebellar infarct/multiple infarct (11.8 percent), and lacunar infarct/ bifrontal subdural effusion (2 percent). Two patients had a normal CT Scan. CONCLUSIONS: Cranial CT scan is advantageous in the diagnosis of TIA, because it is easily available and it provides evidence that either substantiates the diagnosis of cerebral ischemia or suggests an alternative diagnosis. Early CT studies demonstrated non-ischemic etiologies. Most of the TIA occur in less than 6 hours from the onset of symptoms. (Author)

Ischemic Attack, Transient ; Brain Ischemia