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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2002 February;161(1):1-5
Etiologic evaluation and diagnosis of cerebrovascular disease in the elderly
Bilora F. 1, Boccioletti V. 1, Pomerri F. 2, Pagiaro E. 2, Petrobelli F. 1, Girolami A. 1
1 Medical School, Department of Medical and Surgery Sciences, Second Chair of Medicine, University of the Study, Padua;
2 Radiology Institute, University of the Study, Padua
Background. The etiology in 40% of TIA (transient ischemic attack)/Stroke is difficult to identify. We tried to do this with non invasive diagnostic methodology and with the help of three expert doctors (ED): a neurologist, a cardiologist and a neuroradiologist. We then compared the diagnosis of the physician who took care of the patients (D) with that of the experts.
Methods. We studied 149 patients with cerebrovascular diseases but we excluded hemorrhagic stroke. Male patients with TIA presented the common risk factors of atherosclerosis: diabetes, smoking habitus and a tendency to hypertension but no correlation with light or moderate grade of carotid stenosis. Females had a strong prevalence of atrial fibrillation linked with TIA; the males mitral insufficiency and anular aortic calcification correlated with embolic TIA.
Results. CT scan evidenced focal lesions for women’s TIA and multifocal lesions for men’s TIA. There was diagnostic concordance for TIA evaluated by two medical equipes, but not for women’s stroke. The ED were more capable in determining the etio-pathogenetic diagnosis of cerebrovascular disease.
Conclusions. A good evaluation of clinical history and non invasive diagnostic methodology can reduce the undeterminated causes of cerebrovascular disease particularly in the elderly.