What question did this study set out to answer?

To investigate whether blood pressure fluctuations contribute to the progression of repetitive transient ischemic attacks into established lacunar strokes.

January 1, 2003Cerebrovascular Diseases

The Role of Blood Pressure in Lacunar Strokes Preceded by TIAs

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Why the study?

Does pharmacological increase of blood pressure prevent definite stroke in patients with lacunar strokes preceded by TIAs?

Population

6 patients presenting lacunar strokes preceded by repetitive transitory ischaemic attacks, known as…

Design

Case_series

Authors

PLPatrice H. LaliveUniversity of Geneva IMImelda MayorRoyal Manchester Children's Hospital RSRoman SztajzelHôpital de la Tour

Discussion

Member takes

Implication

Hypothesis-generating for induced hypertension in capsular warning syndrome; prospective trials needed before any practice change.

Key Points

To investigate whether blood pressure fluctuations contribute to the progression of repetitive transient ischemic attacks into established lacunar strokes.
Evaluated clinical and hemodynamic courses of 6 consecutive patients presenting with lacunar stroke preceded by repetitive transient ischemic attacks (capsular warning syndrome).
Monitored blood pressure variations during clinical deterioration and assessed responses to full-dose intravenous heparin across all patients and noradrenalin in 1 patient.
All 6 patients exhibited intermittent decreases in blood pressure that coincided directly with neurological worsening, leading to definitive stroke in 4 patients.
Treatment with full-dose intravenous heparin failed to prevent neurological deterioration in all 6 patients, whereas blood pressure stabilization with noradrenalin produced complete symptom resolution in 1 patient.

Structured PICO

Does pharmacological increase of blood pressure prevent definite stroke in patients with lacunar strokes preceded by TIAs?

Population

6 patients presenting lacunar strokes preceded by repetitive transitory ischaemic attacks (TIAs), known as 'capsular warning syndrome'

Intervention

Full-dose intravenous heparin (all 6 patients); noradrenalin (1 patient)

Outcome

Clinical worsening and development of definite strokehard clinical

Pharmacological increase of blood pressure may prevent definite stroke in patients with capsular warning syndrome, suggesting a hemodynamic failure mechanism rather than thromboembolism.

Cite This Study

Lalive et al. (2003) studied this question.

synapsesocial.com/papers/6a7de740d0946debe915069a https://doi.org/10.1159/000070121

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The Role of Blood Pressure in Lacunar Strokes Preceded by TIAs

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

The Role of Blood Pressure in Lacunar Strokes Preceded by TIAs

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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