Bogousslavsky J, Hachinski V C, Boughner D R, Fox A J, Viñuela F, Barnett H J
Arch Neurol. 1986 Mar;43(3):223-8. doi: 10.1001/archneur.1986.00520030015005.
Two hundred fifty consecutive patients with carotid transient ischemic attacks (TIAs) and no previous stroke were assessed with cerebral angiography (95%), two-dimensional echocardiography (86%), electrocardiography (100%), and Holter monitoring (99 selected patients). Angiography disclosed a lesion appropriate to the TIAs in 84%. Lesions also occurred in the asymptomatic carotid artery, but stenosis of more than 75% of the lumen diameter and ulcers were significantly more frequent on the symptomatic side. Twenty-three percent of the patients had a potential source of emboli from the heart, usually in the context of symptomatic heart disease. Among the 205 patients who underwent full angiographic and cardiac investigations, 6% had an isolated potential cardiac source of emboli and 19% had a potential cardiac source of emboli associated with appropriate carotid disease. The search for a potential cardiac source of emboli is strongly indicated in patients with carotid TIAs and known heart disease. In the patients with no history of heart disease, the yield of this search is low, but our results suggest that at least 14 of such patients have an undetected potential cardiac source of emboli. Cardiac and arterial lesions commonly coexist in carotid TIAs.
对250例连续的有颈动脉短暂性脑缺血发作（TIA）且既往无卒中的患者进行了脑血管造影（95%）、二维超声心动图（86%）、心电图（100%）及动态心电图监测（99例选定患者）评估。脑血管造影显示84%的患者有与TIA相符的病变。病变也发生在无症状的颈动脉，但有症状一侧管腔直径狭窄超过75%及溃疡更为常见。23%的患者有潜在的心脏栓子来源，通常是在有症状性心脏病的情况下。在205例接受全面血管造影和心脏检查的患者中，6%有孤立的潜在心脏栓子来源，19%有与适当的颈动脉疾病相关的潜在心脏栓子来源。对于有颈动脉TIA和已知心脏病的患者，强烈建议寻找潜在的心脏栓子来源。在无心脏病史的患者中，这种检查的阳性率较低，但我们的结果表明，至少有14例此类患者有未被发现的潜在心脏栓子来源。心脏和动脉病变在颈动脉TIA中常同时存在。
