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Medicine Miscellaneous 59b07223

Which one of the following excludes history of transient ischaemic attack?

A
Haemorrhage
B
Embolic episodes
C
Thrombotic episodes
D
Complete stroke
High-Yield Explanation
(A) Haemorrhage > An important cause of transient cerebral ischemia is embolization.> In many patients with these attacks, a source is readily apparent in the heart or a major extracranial artery to the head & emboli sometimes are visible in retinal arteries> Moreover, an embolic phenomenon explains why separate attacks may affect different parts of the territory supplied by the same major vessel.> Cardiac causes of embolic ischemic attacks include rheumatic heart disease, mitral valve disease, cardiac arrhythmia, infective endocarditis, atrial myxoma, and mural thrombi complicating myocardial infarction.> Atrial septal defects and patent foramen ovale may permit emboli from the veins to reach the brain ("paradoxical emboli").> An ulcerated plaque on a major artery to the brain may serve as a source of emboli.> Patients with AIDS have an increased risk of developing transient ischemic deficits or strokes.

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