Transient Ischemic Attack Before Nonlacunar Ischemic Stroke in the Elderly

David Della Morte, Pasquale Abete, Ferdinando Gallucci, Anna Scaglione, Daniele D'Ambrosio, Gaetano Gargiulo, Giovanna De Rosa, Kunjan R. Dave, Hung Wen Lin, Francesco Cacciatore, Francesca Mazzella, Generoso Uomo, Tanja Rundek, Miguel A. Perez-Pinzon, Franco Rengo

Research output: Contribution to journalArticlepeer-review


Background: Several studies suggest transient ischemic attack (TIA) may be neuroprotective against ischemic stroke analogous to preinfarction angina's protection against acute myocardial infarction. However, this protective ischemic preconditioning-like effect may not be present in all ages, especially among the elderly. The purpose of this study was to determine the neuroprotective effect of TIAs (clinical equivalent of cerebral ischemic preconditioning) to neurologic damage after cerebral ischemic injury in patients over 65 years of age. Methods: We reviewed the medical charts of patients with ischemic stroke for presence of TIAs within 72 hours before stroke onset. Stroke severity was evaluated by the National Institutes of Health Stroke Scale and disability by a modified Rankin scale. Results: We evaluated 203 patients (≥65 years) with diagnosis of acute ischemic stroke and categorized them according to the presence (n = 42, 21%) or absence (n = 161, 79%) of TIAs within 72 hours of stroke onset. Patients were monitored until discharged from the hospital (length of hospital stay 14.5 ± 4.8 days). No significant differences in the National Institutes of Health Stroke Scale and modified Rankin scale scores were observed between those patients with TIAs and those without TIAs present before stroke onset at admission or discharge. Conclusion: These results suggest that the neuroprotective mechanism of cerebral ischemic preconditioning may not be present or functional in the elderly.

Original languageEnglish
Pages (from-to)257-262
Number of pages6
JournalJournal of Stroke and Cerebrovascular Diseases
Issue number5
Publication statusPublished - Sep 2008


  • Cerebral ischemic preconditioning
  • elderly
  • stroke
  • transient ischemic attack

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Health Professions(all)


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