Cerebral infarction with transient signs (CITS): do TIAs correspond to small deep infarcts in internal carotid artery occlusion?

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Abstract
Among 75 patients in whom internal carotid artery (ICA) occlusion was discovered on angiography, 5 presented with transient ischemic attacks (TIA) without suffering a stroke. Although neurological examination was normal, all had evidence for 1 (in 1 instance 2) hypodense lesion suggesting infarction contralateral to the neurological dysfunction on computed tomography (CT). These infarcts were small and deeply located, being indistinguishable from lacunes in most cases. Cerebral infarction with transient signs (CITS) may be a usual finding in patients with ICA occlusion who suffer isolated TIA. In these cases, CITS may correspond to incomplete cerebral necrosis related to a well-developed collateral supply, or to recurrent ischemia in the region of an old silent infarct. CITS should be differentiated from TIA, which may be diagnosed only in absence of visible structural lesion.