Long‐Term Prognosis of Infratentorial Transient Ischemic Attacks and Minor Strokes

This study was performed to gather information about long-term prognosis after infratentorial transient ischemic attacks and minor strokes and about the factors influencing it. Methods We included 226 patients with transient ischemia and 169 patients with a minor stroke of the brain stem/cerebellum consecutively admitted to a neurological department. Medical records and the findings of computed tomography, Doppler ultrasonography, and angiography were evaluated retrospectively. Follow-up information was gathered from the patients and their physicians by questionnaires. Complete follow-up information was available for 381 patients. Results During a mean follow-up of 3.9 years, 15.7% of the 381 patients suffered a stroke and 6.8% a myocardial infarction; 15% died. Kaplan-Meier estimates revealed a cumulative stroke rate of 5.1% within the first year and a risk of stroke, myocardial infarction, or death of any cause of 9.8%. In a proportional hazards model, the time-dependent risk of stroke was significantly increased by increasing age (p=0.018), minor stroke (p=0.0005), hypertension (p=0.022), previous stroke (p=0.0006), and carotid artery occlusive disease (p=0.0065). The probability of stroke, myocardial infarction, or death was influenced by age (p=0.0001), minor stroke (p=0.006), diabetes (p=0.015), previous stroke (p=0.002), infarct on a computed tomogram (p=0.041), and carotid artery disease (p=0.032). Conclusions Long-term prognosis after brain stem/cerebellar transient ischemic attacks and minor strokes is significantly influenced by age, diabetes, hypertension, previous stroke, and concomitant carotid artery disease. Patients with transient ischemic attacks have a better prognosis than those with minor stroke.

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