One hundred and ten patients who had presented with amaurosis fugax and were treated medically were studied retrospectively. Follow up from the time of presentation was six to nineteen years with a median of eight years. The mortality and frequency of strokes in this group was compared with populations matched for age and sex. Life expectancy in patients with amaurosis fugax was reduced. Ischaemic heart disease was the most frequent cause of death and occurred at a greater rate than in the general population (p less than 0.01). The indicence of stroke was higher than in the Oxfordshire Community Stroke Project 1981-1983 (p less than 0.01). Comparing our results to those published for cerebral transient ischaemic attacks, patients with amaurosis fugax have a similar mortality rate but probably have a lower incidence of stroke. Patients with amaurosis fugax who have an occluded or narrowed proximal internal carotid artery have a greater risk of subsequent stroke than those with a normal carotid artery, or an arteriogram (p less than 0.01).
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