Attenuated stroke severity after prodromal TIA : A role for ischemic tolerance in the brain?

Ischemic tolerance has been extensively studied in experimental models of heart and brain ischemia. While there is some clinical evidence of ischemic tolerance in the heart, it is not known whether the same is true for the human brain. We conducted a retrospective case-control study in 148 stroke pa...

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Bibliographic Details
Published in:Stroke (1970) 1999-09, Vol.30 (9), p.1851-1854
Main Authors: WEIH, M, KALLENBERG, K, BERGK, A, DIRNAGL, U, HARMS, L, WERNECKE, K. D, EINHÄUPL, K. M
Format: Article
Language:English
Subjects:
Adaptation, Physiological
Aged
Biological and medical sciences
Case-Control Studies
Cerebrovascular Disorders - complications
Cerebrovascular Disorders - physiopathology
Female
Glasgow Coma Scale
Humans
Ischemic Attack, Transient - complications
Ischemic Attack, Transient - physiopathology
Male
Medical sciences
Middle Aged
Multivariate Analysis
Neurology
Prognosis
Retrospective Studies
Severity of Illness Index
Vascular diseases and vascular malformations of the nervous system
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Summary:Ischemic tolerance has been extensively studied in experimental models of heart and brain ischemia. While there is some clinical evidence of ischemic tolerance in the heart, it is not known whether the same is true for the human brain. We conducted a retrospective case-control study in 148 stroke patients with and without antecedent TIA. Despite no significant differences in baseline characteristics, independence (Rankin scale score of 0 to 1) and favorable outcome (Glasgow Coma Scale score of 5) were significantly associated with prior TIA in univariate analysis. After correction for other cardiovascular risk factors, TIA before stroke also was an independent predictor of mild stroke (Canadian Neurological Scale score of > or= 6.5) in multivariate models (absolute difference 21.6%; P=0.01). Assuming that a TIA represents an adequate stimulus to elicit ischemic tolerance, our results suggest that ischemic tolerance might occur in the human brain.
ISSN:0039-2499
1524-4628
DOI:10.1161/01.STR.30.9.1851