+ Site Statistics
References:
52,654,530
Abstracts:
29,560,856
PMIDs:
28,072,755
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn

+ Translate
+ Recently Requested

Intracranial artery stenosis or occlusion predicts ischemic recurrence after transient ischemic attack



Intracranial artery stenosis or occlusion predicts ischemic recurrence after transient ischemic attack



Ajnr. American Journal of Neuroradiology 34(1): 185-190



Patterns of DWI findings that predict recurrent ischemic events after TIA are well-established, but similar assessments of intracranial MRA findings are not available. We sought to determine the imaging characteristics of MRA that are predictive of early recurrent stroke/TIA in patients with TIA. We performed a retrospective analysis of 129 consecutive patients with a clinical diagnosis of TIA in whom MR imaging was done within 24 hours of symptom onset. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of >50% stenosis or occlusion of symptomatic intracranial arteries for recurrent stroke/TIA at 7 days after TIA. We used logistic regression analysis to adjust for the clinical ABCD(2) score. We performed this analysis for symptomatic steno-occlusive lesions at any site and symptomatic steno-occlusive lesions on proximal large intracranial arteries (internal carotid artery, vertebral artery, basilar artery, and circle of Willis). Forty-two (32.5%) patients had acute ischemic lesions on DWI; 16 (12.4%) had significant MRA lesions, of which 11 (8.5%) were on proximal vessels. Nine patients had early recurrence (TIA, 7; minor stroke, 2). Only patients with proximal MRA lesions were at higher risk of early recurrence independent of the ABCD(2) score (adjusted odds ratio, 5.5; 95% confidence interval, 1.1-27.8; P = .04). Proximal lesions of cerebral arteries seen on MRA were predictive of recurrent stroke/TIA at 7 days. These findings suggest that MRA could be used to improve the selection of patients with TIA at high risk of early recurrent stroke/TIA.

(PDF emailed within 0-6 h: $19.90)

Accession: 053939381

Download citation: RISBibTeXText

PMID: 22678847

DOI: 10.3174/ajnr.A3144


Related references

Prolonged Perfusion Predicts Recurrent Ischemic Stroke but not Transient Ischemic Attack in Patients with Symptomatic Intracranial Stenosis. Current Neurovascular Research 14(2): 149-157, 2017

C-reactive protein predicts further ischemic events in first-ever transient ischemic attack or stroke patients with intracranial large-artery occlusive disease. Stroke 34(10): 2463-2468, 2003

MRI Profile and Collateral Status in Patients with a Transient Ischemic Attack and an Intracranial Artery Occlusion. Journal of Neuroimaging, 2018

Large-artery stenosis predicts subsequent vascular events in patients with transient ischemic attack. Journal of Clinical Neurology 3(4): 169-174, 2007

Adequate Platelet Function Inhibition Confirmed by Two Inductive Agents Predicts Lower Recurrence of Ischemic Stroke/Transient Ischemic Attack. Biomed Research International 2017: 3504950-3504950, 2018

Early stroke risk after transient ischemic attack among individuals with symptomatic intracranial artery stenosis. Archives of Neurology 65(6): 733-737, 2008

Limb-shaking transient ischemic attack masquerading as lumbar radiculopathy from pericallosal artery stenosis treated successfully with intracranial angioplasty and stenting. Journal of Stroke and Cerebrovascular Diseases 19(2): 169-173, 2010

Development of ischemic stroke or transient ischemic attack in patients with significant internal carotid artery stenosis is associated with hyperhomocysteinemia and heterozygosity for human platelet antigen 1. Blood 96(11 Part 1): 646a, November 16, 2000

Percutaneous transluminal angioplasty and stenting for severe stenosis of the intracranial extradural internal carotid artery causing transient ischemic attack or minor stroke. Interventional Neuroradiology 21(4): 511-519, 2015

Metabolomics predicts stroke recurrence after transient ischemic attack. Neurology 84(1): 36-45, 2015

C-reactive protein predicts further ischemic events in transient ischemic attack patients. Acta Neurologica Scandinavica 115(1): 60-66, 2006

Intracranial large vessel occlusion as a predictor of decline in functional status after transient ischemic attack. Stroke 42(1): 44-47, 2011

Redefinition of transient ischemic attack improves prognosis of transient ischemic attack and ischemic stroke: an example of the will rogers phenomenon. Stroke 42(12): 3612-3613, 2012

Computed tomography in patients with transient ischemic attacks when is a transient ischemic attack not a transient ischemic attack but a stroke. Journal of Neurology 237(4): 257-261, 1990

Low ankle-brachial index predicts cardiovascular risk after acute ischemic stroke or transient ischemic attack. Stroke 40(12): 3700-3705, 2010