Accidents ischémiques transitoires et accidents vasculaires cérébraux mineurs

Sixty-five per cent of new ischemic cerebrovascular accidents occurring in Western Europe are either transient ischemic attacks (TIA; 30%) or minor strokes (35%). These patients are younger as compared to patients with more severe strokes and have less often overt atherosclerotic disease. This renders preventive measures potentially more efficient as patients receive care at an earlier stage of their cardiovascular and atherosclerotic disease. Management of these patients in TIA clinics instead of traditional hospitalization is more adapted to their profile and is associated with a 50 to 80% reduction of early recurrent strokes. It is also associated with a reduction of the occurrence of disability and with a reduction of health care cost. TIA is associated in one-third of patients with cognitive impairment, mainly impairment of working memory and reduction in speed of information processing. TIA is also associated with anxiety symptoms and with posttraumatic stress disorder in one-third of patients. This has negative consequences on observance and on the occurrence of subsequent cardiovascular events.