The duration of symptoms in transient ischemic attack

Background: The majority of TIAs last from 2 to 15 minutes, although some m ay be of long duration. Objective: We examined factors related to the durat ion of TIAs to identify the relationship to clinical characteristics. Metho ds: We performed brain imaging studies as well as angiographic and cardiac examinations in 81 consecutive patients (64 men and 17 women, age 65.8 +/- 9.9 years) with carotid TLAs. We evaluated risk factors (hypertension, diab etes mellitus, hyperlipidemia, alcohol consumption, and smoking), potential cardiac sources of emboli, and arterial stenosis greater than or equal to 50% in diameter in the carotid or middle cerebral arteries. Recent infarcts were assessed with CT or MRI. We correlated duration of symptoms with clin ical data. Results: The presence of emboligenic cardiac or arterial disease s was significantly related to the duration of symptoms. With sensitivity-s pecificity curve analysis for detecting such diseases, the duration of symp toms could be divided into short-duration TLAs (<60 minutes, n = 41) or lon g-duration TIAs (greater than or equal to 60 minutes, n = 40). Patients wit h long-duration TIAs had emboligenic cardiac or arterial diseases more freq uently than those with short-duration TIAs (86% versus 46%, p < 0.001). Rec ent infarcts were also more frequent in patients with long-duration Tills t han they were in patients with short-duration TLAs (45% versus 21%, p < 0.0 5). Conclusions: Short-duration and long-duration TIAs can be separated bas ed on symptom duration of <1 hour or greater than or equal to 1 hour. Patie nts with long-duration TLAs should be examined more closely for the presenc e of cardiac and arterial diseases than those with short-duration TIAs.