Tanaka Koji, Uehara Toshiyuki, Kimura Kazumi, Okada Yasushi, Hasegawa Yasuhiro, Tanahashi Norio, Suzuki Akifumi, Nakagawara Jyoji, Arii Kazumasa, Nagahiro Shinji, Ogasawara Kuniaki, Uchiyama Shinichiro, Matsumoto Masayasu, Iihara Koji, Toyoda Kazunori, Minematsu Kazuo
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology, Neurological Institutes, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Neurology, Hyogo Brain and Heart Center, Himeji, Japan.
J Stroke Cerebrovasc Dis. 2018 Jun;27(6):1711-1716. doi: 10.1016/j.jstrokecerebrovasdis.2018.01.031. Epub 2018 Mar 8.
A transient visual symptom (TVS) is a clinical manifestation of transient ischemic attack (TIA). The aim of this study was to investigate differences in clinical characteristics among subtypes of TVS using multicenter TIA registry data.
Patients with TIA visiting within 7 days of onset were prospectively enrolled from 57 hospitals between June 2011 and December 2013. Clinical characteristics were compared between patients with 3 major subtypes of TVS (transient monocular blindness [TMB], homonymous lateral hemianopia [HLH], and diplopia).
Of 1365 patients, 106 (7.8%) had TVS, including 40 TMB (38%), 34 HLH (32%), 17 diplopia (16%), and 15 others/unknown (14%). Ninety-one patients with 1 of the 3 major subtypes of TVS were included. Symptoms persisted on arrival in 12 (13%) patients. Isolated TVS was significantly more common in TMB than in HLH and diplopia (88%, 62%, and 0%, respectively; P < .001). Duration of symptoms was shorter in patients with TMB than those with HLH (P = .004). The ABCD score was significantly lower in patients with TMB compared with those with HLH and diplopia (median 2 [interquartile range 2-3] versus 3 [2-4] and 4 [2-5], respectively; P = .005). Symptomatic extracranial internal carotid artery stenosis or occlusion was seen in 14 (16%) patients, and was more frequent in TMB than in HLH and diplopia (28%, 9%, and 0%, respectively; P = .015).
TVS was an uncommon symptom in our TIA multicenter cohort. Some differences in clinical characteristics were found among subtypes of TVS.
短暂性视觉症状（TVS）是短暂性脑缺血发作（TIA）的一种临床表现。本研究旨在利用多中心TIA注册数据调查TVS各亚型之间临床特征的差异。
2011年6月至2013年12月期间，前瞻性纳入了来自57家医院、发病7天内就诊的TIA患者。比较了TVS 3种主要亚型（一过性单眼盲[TMB]、同向性偏盲[HLH]和复视）患者的临床特征。
1365例患者中，106例（7.8%）有TVS，包括40例TMB（38%）、34例HLH（32%）、17例复视（16%）和15例其他/不明（14%）。纳入了91例患有3种主要TVS亚型之一的患者。12例（13%）患者到达时症状仍持续存在。孤立性TVS在TMB中比在HLH和复视中更常见（分别为88%、62%和0%；P < .001）。TMB患者的症状持续时间比HLH患者短（P = .004）。与HLH和复视患者相比，TMB患者的ABCD评分显著更低（中位数分别为2[四分位间距2 - 3]与3[2 - 4]和4[2 - 5]；P = .005）。14例（16%）患者出现有症状的颅外颈内动脉狭窄或闭塞，在TMB中比在HLH和复视中更常见（分别为28%、9%和0%；P = .015）。
在我们的TIA多中心队列中，TVS是一种不常见的症状。在TVS各亚型之间发现了一些临床特征上的差异。
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