摘要：

Not every TIA is primarily vascular. – Three patients, two women aged 72 and 45 years, and a man aged 80 years, presented with transient neurological deficits due to a brain tumour, a glioblastoma multiforme and two meningiomas respectively. A fourth patient, an 84-year-old man, had a transient ischaemic attack (TIA) with a meningioma as an incidental finding. The first woman had normal CT findings, but MRI revealed the neoplasm. Symptoms included motor loss, sensory disturbances, dysphasia and dysarthria, lasting from 30 seconds up to 10 minutes. The first two patients had surgery; the first one later died when the tumour recurred. The other two patients still exhibit a spontaneous recovery. Of all patients with a clinical presentation of a TIA, 0.4-1% harbour a brain tumour. Clinical symptoms do not distinguish 'transient tumour attacks' from TIAs with a primarily vascular origin. Transient tumour attacks are mainly seen with meningiomas, and to a lesser extent with highgrade gliomas. Changes in intracranial pressure leading to focal ischaemia may explain the occurrence of this phenomenon. Apart from intracerebral tumours, non-vascular entities mimicking TIAs can also be seen with demyelinating processes, metabolic disturbances, epilepsy or migraine. Brain imaging is always required in patients with transient neurological deficits. A CT scan may provide false-negative results and in case of doubt, MRI is the preferred diagnostic tool. literatuur 1 Ross RT. Transient tumor attacks. Arch Neurol 1983;40:663-6. 2 Gijn J van, Kappelle LJ. TIA'tje . . . aspirientje? Ned Tijdschr Geneeskd 1995;139:2708-11. 3 Cameron EW. Transient ischaemic attacks due to meningioma – report of 4 cases. Clin Radiol 1994;49:416-8. 4 Daly DD, Svien HJ, Yoss RE. Intermittent cerebral symptoms with meningiomas. Arch Neurol 1961;5:287-93. 5 Davidovitch S, Gadoth N. Neurological deficit-simulating transient ischemic attacks due to intracranial meningioma. Eur Neurol 1988; 28:24-6. 6 Walker R, Lieberman AN, Pinto R, George A, Ransohoff J, Trubek M, et al. Transient neurologic disturbances, brain tumors, and normal computed tomography scans. Cancer 1983;52:1502-6. 7 The UK TIA Study Group. lntracranial tumours that mimic transient cerebral ischaemia: lessons from a large multicentre trial. J Neurol Neurosurg Psychiatry 1993;56:563-6. 8 Garcia-Monco JC, Marrodan A, Foncea Beti N, Gomez Beldarrain M. Stroke and transient ischemic attack-mimicking conditions: a prospective analysis of risk factors and clinical profiles at a general hospital. Neurologia 2002;17:355-60. Ned Tijdschr Geneeskd 2003 13 september;147(37) 1771 9 Moster M, Johnston DE, Reinmuth OM. Chronic subdural haematoma with transient neurological defecits; a review of 15 cases. Ann Neurol 1983;14:539-42. 10 Rausing A, Ybo W, Stenflo J. Intracranial meningioma – a population study of ten years. Acta Neurol Scand 1970;46:102-10. 11 Rother J, Schreiner A, Wentz KU, Hennerici M. Hypoglycemia presenting as basilar artery thrombosis. Stroke 1992;23:112-3. 12 Twomey JA, Espir ML. Paroxysmal symptoms as the first manifestations of multiple sclerosis. J Neurol Neurosurg Psychiatry 1980;

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