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In younger patients the presenting transient ischemic attack occurred less frequently in the vertebrobasilar territory(9%versus 21%,P=.03).Risk factor analysis revealed significant differences between the groups,with hypertension,previous smoking history,ischemic heart disease,and peripheral vascular disease being more common in the older group.Migraine and valvular heart disease were more common in the younger group. Approximately 60%of the patients in each group had multiple etiologies.The most common etiology was atheromatous cerebrovascular disease in both groups((74%versus 37%[P<.0001]in the older and younger groups, respectively).Other significant etiologic differences included fibromuscular dysplasia,mitral valve prolapse,and use of oral contraceptives occurring more frequently in the younger group,and ischemic heart disease occurring more frequently in the older group.This study reveals the clinical and etiologic differences between younger and older patients with transient ischemic attack.The importance of multiple etiologies in both groups of patients has diagnostic and management implications. |
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cerebrovascular accident cerebrovascular accident,young adult cerebrovascular disease,risk factors in migraine mitral valve lesion old age,neurology of risk factors transient ischemic attack transient ischemic attack,etiology of transient ischemic attack,young adult
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