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Title: The capsular warning syndrome: pathogenesis and clinical features.
Austin Authors: Donnan, Geoffrey A ;O'Malley, H M;Quang, L;Hurley, S;Bladin, Peter F 
Affiliation: Department of Neurology, Austin Hospital, Melbourne, Australia
Issue Date: 1-May-1993
Publication information: Neurology; 43(5): 957-62
Abstract: Transient ischemic attacks (TIAs) are not homogeneous and may consist of subsets with mechanisms as varied as their stroke counterparts. We describe a form of TIA in 50 patients where crescendo episodes of ischemia were restricted to the region of the internal capsule, usually causing symptoms affecting face, arm, and leg. These patients composed 4.5% of a consecutive series of patients admitted with TIAs over a 15-year period and 33% of all TIAs classified as subcortical. We believe that the ischemia was most often due to hemodynamic phenomena in diseases, single, small penetrating vessels. When cerebral infarction developed, it was usually lacunar and involved a single penetrating vessel, although occasionally striatocapsular or anterior choroidal artery territory infarction occurred. There was no evidence of artery-to-artery or heart-to-artery embolism. Resistance to various forms of therapy, including hemodiluting, anticoagulant, and thrombolytic agents, was common. Because of dramatic and easily recognizable clinical presentation, apparent specific pathophysiologic mechanism, and the development of early capsular stroke in a high proportion of cases (42%), we have termed this the "capsular warning syndrome."
Gov't Doc #: 8492952
Journal: Neurology
Type: Journal Article
Subjects: Aged
Basilar Artery.physiopathology
Brain Stem.blood supply.physiopathology
Cerebral Cortex.blood supply.physiopathology
Follow-Up Studies
Ischemic Attack, Transient.physiopathology.radiography
Middle Aged
Retrospective Studies
Time Factors
Tomography, X-Ray Computed
Appears in Collections:Journal articles

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