Bibliographic record
Abstract
OBJECTIVE: To delineate clinical manifestations and identify hemodynamic pathogenesis of Basilar transient ischemic attacks that are symptomatic of Carotid artery stenoses. BACKGROUND: Transient ischemic attack (TIA) is clinically differentiated into either Carotid artery insufficiency with cerebral hemispheric symptomatology usually of contralateral hemiparesis-hypalgesia and dysphasia or Basilar with brain stem manifestations commonly of cranial nerve(s) dysfunction and/or simultaneous bilateral limb motor/sensory loss. Anomalous clinical presentations of Basilar TIAs that investigations revealed only significant Carotid artery stenoses are rarely recognized albeit odd reports exist of Carotid stenoses induced Basilar TIAs being relieved by carotid endarterectomy. DESIGN/METHODS: Profiles of 5,000 patients screened over 5 years in one NASCET center were reviewed for Basilar artery symptoms fulfilling criteria for TIA as defined by the ad hoc Committee of the Advisory Council for NINCDS of NIH and that were improved by appropriate treatments mostly endarterectomy of ultrasonic and/or angiographic confirmed significant carotid artery stenoses but normal vertebrobasilar arteries and no other tenable explanation for the stroke semiology. RESULTS: Basilar TIAs induced by Carotid artery stenoses identified are: Drop Attacks of sudden falls with preserved consciousness; Paraparetic Transients of episodic weak legs; Paraparesthetic Transients of episodic tingling/numb legs; Paraparetic-paresthetic Transients of episodic weak, tingling/numb legs and Quadriparetic Transients of episodic tetraparesis. Pathophysiologic mechanisms likely operative either singly or jointly causing Basilar TIA from Carotid stenoses include: Intracerebral "steal" from Basilar to Carotid circulation; Bi-hemispheric hypoperfusion from bilateral Carotid stenoses exacerbated by systemic hypotension resulting in "watershed" ischemia; Ipsilateral hemispheric hypoperfusion plus contralateral artery-to-artery embolization from similarly diseased Carotid arteries and Simultaneous bi-hemispheric (crossed) embolization from unilateral carotid ulcerative stenosis. CONCLUSIONS: Otherwise unexplainable Basilar TIAs maybe manifestations of significant Carotid artery disease and should be treated as symptomatic Carotid artery stenosis. Study Supported by: Self-supported.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".