Life history of patients with transient ischemic attacks and essentially normal angiograms.

Eighty-three patients, 43 women and 40 men, with hemispheric transient ischemic attacks (TIAs) and normal angiograms were studied. Fifty-two of the patients had a single episode of transient ischemia, whereas 31 had multiple episodes prompting initial evaluation. Follow-up ranging from 3 to 132 months was obtained for all patients. In this period, six patients suffered a cerebrovascular accident and five had further hemispheric TIAs. These results are in contrast to our earlier data, which suggested a benign prognosis in this group of patients. Results of this updated study show that the prognosis of patients with hemispheric TIAs and normal angiograms is not so benign as originally reported. Those patients with multiple events before initial evaluation are at increased risk of subsequent cerebrovascular accident or TIA. Close observation of this group of patients is recommended.