Reversible ischemic neurological deficit (RIND) is defined as a stroke due to ischemic brain injury with weakness, paresis/paralysis, speech abnormalities, etc which last from anywhere between a day to 21 days followed by either a complete recovery or residual deficits. Loeb et al [1] described the following clinical presentation in RIND:

• rare condition with an incidence of less than 5% amongst all strokes
• commonly occurs in the territory of the internal carotid artery with almost 70% occlusion of the artery
• is of sudden onset
• loss of consciousness is rare
• there are no specific imaging findings
• arteriography often shows arterial occlusion
• is associated with a poor prognosis and death in patients with massive hemorrhagic infarcts.

The clinical features may completely dissipate if thrombolysis is performed soon after the formation of the thrombus [1].

RIND indicates a tiny brain stroke with recovery within a few weeks and should be differentiated from a transient ischemic attack (TIA), which is associated with a reversal of symptoms within twenty-four hours. Currently, the term "RIND" is not used commonly [2] as the diagnosis is based on tissue appearance on imaging studies rather than on the duration of the symptoms.

• Coronary Atherosclerosis

  Obesity, hyperlipidemia, sedentary lifestyle, and cigarette smoking, are major factors (they are also implicated as causes of coronary atherosclerosis and insufficiency). [dartmouth.edu]

• Stroke

  Abstract The benefit of carotid endarterectomy (CE) in preventing recurrent stroke and improving survival in the patient who has sustained a reversible ischemic neurologic deficit (RIND) or stroke is still controversial. [ncbi.nlm.nih.gov]

  |Completed stroke (disorder)|Extension of cerebrovascular accident|Extension of cerebrovascular accident (disorder)|Extension of stroke|Inferior cerebellar artery syndrome|Ischaemic stroke|Ischaemic stroke without coma|Ischemic stroke|Ischemic stroke [averbis.com]

  Doppler testing of the internal carotid arteries is important to diagnose carotid artery stenosis as strokes can be associated with up to 70% stenosis. [symptoma.com]

  Stroke 38: 1655–711 CrossRef PubMed Google Scholar Hacke W, Kaste M, Bogousslavsky J et al. (2003) European stroke initiative recommendations for stroke management-update 2003. [link.springer.com]

The diagnosis of RIND is based on a thorough history, physical, neuropsychiatric, and cognitive evaluation along with laboratory and imaging studies. History should elicit the onset, duration, and progress of the neurological deficits as well as a history of co-morbid factors like hypertension, diabetes, etc.

Laboratory tests include complete blood count, blood sugar levels, lipid profile and other tests indicated by clinical presentation. An electrocardiogram may show evidence of cardiac conduction anomalies and while echocardiography may reveal the source of the thrombus and cardiac function. Doppler testing of the internal carotid arteries is important to diagnose carotid artery stenosis as strokes can be associated with up to 70% stenosis.

Currently, the features of the brain tissue on imaging studies like high-resolution computed tomography (HRCT) and diffusion-weighted magnetic resonance imaging (MRI) rather than the time (duration) of deficits is used to detect the condition [2]. CT scans can demonstrate hemorrhage while MRI can detect even tiny infarctions. Several reports indicate that there are very few differences between TIAs and RIND on imaging studies [3] with extracranial abnormalities appearing identical in patients with TIAs, RIND and minor strokes [4] [5]. This suggests that the three types of strokes differ quantitatively but not qualitatively and are therefore regarded as a continuation of the same pathological process [6] [7]. The infarcts are usually of the lacunar type in all three groups with RIND patients having small deep infarcts [8]. Arteriography may help to identify the occlusive thrombus in these patients.

Treatment & Monitoring What are the treatments for the condition? Most people with transient ischemic attacks are treated right away with aspirin and then with blood thinners if they do not have bleeding into the brain. [medicineonline.com]

Handbook of Stroke, Second Edition is a user-friendly one-stop guide to the clinical management of patients with cerebrovascular disorders—from clinical and laboratory assessment, differential diagnosis, and initial management, to medical and surgical treatment [books.google.com]

Prompt recognition of cerebrovascular events is important to prevent complications such as cerebral edema, seizures, and aspiration, as well as to use new treatments for stroke. [ncbi.nlm.nih.gov]

Stroke, Second Edition is a user-friendly one-stop guide to the clinical management of patients with cerebrovascular disorders—from clinical and laboratory assessment, differential diagnosis, and initial management, to medical and surgical treatment, prognosis [books.google.com]

[…] occurs in the territory of the internal carotid artery with almost 70% occlusion of the artery is of sudden onset loss of consciousness is rare there are no specific imaging findings arteriography often shows arterial occlusion is associated with a poor prognosis [symptoma.com]

Publication Details First-Page Preview Abstract A hospital-based series of 712 patients with either transient ischemic attacks (TIAs) or reversible ischemic neurologic deficits (RINDs) was followed prospectively for 4 years in order to determine the long-term prognosis [karger.com]

However, not all TIAs and minor strokes have the same prognosis. [academic.oup.com]

Johnston SC, Gress DR, Browner WS, Sidney S: Short-term prognosis after emergency department diagnosis of TIA. JAMA 2000, 284 :2901–2906. PubMed CrossRef Google Scholar 29. [link.springer.com]

Etiology Risk factors for TIA are the same as those for ischemic stroke. [merckmanuals.com]

Reversible ischemic neurologic deficit (RIND) Reversible ischemic neurologic deficit (RIND) is similar to a TIA in etiology. [emsworld.com]

Right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., infarction, anterior cerebral artery), and etiology (e.g., embolic infarction). [icd10data.com]

The infectious etiology of chronic rheumatic diseases. Semin Arthritis Rheum. 1987 Aug;17(1):1–23. [PubMed] [Google Scholar] Schachter J. Chlamydial infections (third of three parts). N Engl J Med. 1978 Mar 9;298(10):540–549. [ncbi.nlm.nih.gov]

Infectology (71) Gastroenterology and Hepatology (66) Pharmacology (62) Emergency Medicine (55) Respiratory Medicine (55) Biophysics (53) Histology, Embryology (51) Anatomy (50) Endocrinology, Metabolism (48) Microbiology (45) Obstetrics, Gynaecology (44) Epidemiology [portal.mefanet.cz]

Epidemiological impact in the United States of a tissue-based definition of transient ischemic attack. Stroke. 2003; 34: 919–924.LinkGoogle Scholar 33 Saver JL, Albers GW, Easton JD, for the TIA Working Group. [ahajournals.org]

Morgenstern EPIDEMIOLOGY AND USUAL CAUSES OF CEREBROVASCULAR DISEASE Stroke is a clinical syndrome characterized by rapidly developing signs or symptoms, or both, of focal neurologic dysfunction with no obvious cause other than vascular origin. [thoracickey.com]

Feigin VL, Lawes CM, Bennett DA, Anderson CS (2003) Stroke epidemiology: a review of population-based studies of incidence, prevalence, and casefatality in the late 20th century. [link.springer.com]

Chapter 37: pathogenesis, classification, and epidemiology of cerebrovascular disease. In: Rowland LP, Pedley TA, eds. Merritt’s Neurology. 12 th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2010. [demosmedical.com]

Gain fresh perspectives and up-to-date insights from the world’s leading authorities on the pathophysiology, diagnosis, and management of stroke. [books.google.com]

It is suggested that TIAs, including AF, and RIND should be regarded as separate entities from a pathophysiological and clinical point of view. [ncbi.nlm.nih.gov]

This article provides a historical perspective on the evolution of the definition of TIA and reviews the associated pathophysiology and symptoms. [medscape.com]

This edition includes cutting-edge information on acute stroke treatment, cerebrovascular disease genetics, primary stroke prevention, management of unruptured intracranial aneurysms, and the newest therapies for various stroke-related symptoms and disorders [books.google.com]

Prevention & Expectations What can be done to prevent the condition? Transient ischemic attacks can be minimized by addressing known risk factors for stroke. [medicineonline.com]

Prompt recognition of cerebrovascular events is important to prevent complications such as cerebral edema, seizures, and aspiration, as well as to use new treatments for stroke. [ncbi.nlm.nih.gov]

1. Loeb C, Priano A, Alabano C. Strokes with full recovery. In: Meyer JS, Lechner H, Reivich M, Eichorn O, editors. Cerebral Vascular Disease. Stuttgart: Georg Thieme. 1973: 15-21.
2. Easton JD, Saver JL, Albers GW, et al. Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. Stroke. 2009;40:2276–2293.
3. Calandre L, Gomara S, Bermejo F, et al. Clinical CT correlations in TIA, RIND, and Strokes with minimum residuum. Stroke. 1984; 15: 4: 663-666.
4. Olsson JE, Muller R, Bemeli S. Long-term anticoagulant therapy for TIAs and minor strokes with minimum residuum. Stroke 1976; 4: 444- 451
5. Bardin JA, Bernstein EF, Humber PB, et al. Is Carotid endarterectomy beneficial in prevention of recurrent stroke? Arch Surg 1982; 117: 1401-140
6. Ladurner G, Sager WD, Iliff LD, Lechner H. A correlation of clinical findings and CT in ischemic cerebrovascular disease. Eur Neurol 1979;18:281-8.
7. Barnett HJM. Stroke prevention. In: Ross Russell RW, ed. Vascular diseases of the nervous system. Edinburgh 1983; 405-27.
8. Koudstaal PJ, van Gijn J, Frenken CWGM, et al. TIA, RIND, minor stroke: a continuum, or different subgroups? Journal of Neurology and Psychiatry. 1992; 55:95-97