Discussion

Easton, J D; Albers, Gregory W.; Caplan, Louis R.; Saver, Jeffrey; Sherman, David G.

doi:10.1212/wnl.62.8_suppl_6.s29

Cited by 56 publications

(55 citation statements)

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“…Attempts to refine the definition remain unresolved, in part because of a lack of an imaging standard for distinguishing ischemia from infarction. 20,21 In particular, the extent to which early DWMRI imaging abnormalities signify irreversible ischemic infarction is not clear. 22,23 Because disabling stroke is uncontroversially distinguished from TIA and represents an important patient oriented outcome, we chose this as our stroke outcome definition.…”

Section: Discussionmentioning

confidence: 99%

Early Diffusion Weighted MRI as a Negative Predictor for Disabling Stroke After ABCD ² Score Risk Categorization in Transient Ischemic Attack Patients

Asimos

Rosamond

Johnson

et al. 2009

Stroke

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Background and Purpose-The prognostic value early diffusion-weighted magnetic resonance imaging (DWMRI) adds in the setting of transient ischemic attack (TIA), after risk stratification by a clinical score, is unclear. The purpose of this study is to evaluate, after ABCD 2 score risk categorization in admitted TIA patients, whether negative DWMRI performed within 24 hours of symptom onset improves on the identification of patients at low risk for experiencing a disabling stroke within 90 days. Methods-At 15 North Carolina hospitals, we enrolled a prospective nonconsecutive sample of admitted TIA patients. We excluded patients not undergoing a DWMRI within 24 hours of admission and patients for whom a dichotomized (Յ or Ͼ3) ABCD 2 score could not be calculated. We conducted a medical record review to determine disabling ischemic stroke outcomes within 90 days. Results-Over 35 months, 944 TIA patients met inclusion criteria, of whom 4% (nϭ41) had a disabling ischemic stroke within 90 days. In analyses stratified by low versus moderate/high ABCD 2 score, the combination of a low risk ABCD

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Section: Discussionmentioning

confidence: 99%

Early Diffusion Weighted MRI as a Negative Predictor for Disabling Stroke After ABCD ² Score Risk Categorization in Transient Ischemic Attack Patients

Asimos

Rosamond

Johnson

et al. 2009

Stroke

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“…The day of the operation was defined as Day 1. Ischemic strokes and intracerebral hemorrhages were differentiated by the findings on brain CT. TIA was defined as a transient episode lasting no more than 1 hour, with complete recovery [8]. Ischemic stroke etiology was determined using the TOAST classification [1,18].According to the clinical and radiological findings, strokes were classified into: right hemispheric, left hemispheric, or vertebrobasilar (brainstem).…”

Section: Methodsmentioning

confidence: 99%

Strokes after cardiac surgery: mostly right hemispheric ischemic with mild residual damage

et al. 2007

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“…Other authors advocate a new definition or replacement of the term. 15,16 In a stroke quality assessment study, we compared a large representative cohort of hospitalized TIA and stroke patients. Diagnostic workup, length of hospital stay, in-hospital complications, and outcome (including death or disability) at discharge and after 6 months were documented.…”

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confidence: 99%

Transient Ischemic Attacks Are More Than “Ministrokes”

Daffertshofer

Mielke

Pullwitt

et al. 2004

Stroke

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Background and Purpose-Transient ischemic attacks (TIAs) are warning signs of stroke. Recently, the hypothesis was raised that TIA bears a significant risk for death and dependence and requires the same complex diagnostic workup as a complete stroke. Methods-We prospectively collected pre-and in-hospital procedures, symptoms, outcome, complications, and therapies from a representative sample of all stroke-treating hospitals (nϭ82) in southwest Germany. Follow-up was attempted 6 months after discharge. End points were death or dependence in activities of daily living (Barthel Index Ͻ95, modified Rankin Scale (mRS) of 3 to 6, or institutionalization in a nursing home). Results-1380 TIA patients and 3855 stroke patients entered the database. During hospital stay, stroke incidence was 8%for TIA patients and another 5% within the first half-year. Similarly, for ischemic stroke (IS) patients these figures were 7% and 6% (PϾ0.05), respectively. Two percent of TIA patients died in hospital (5% afterward) compared with 9% of stroke patients (10% afterward, PϽ0.001). Seventeen percent TIA compared with 38% IS patients (PϽ0.05) were dependent at follow-up. Whereas an estimated preexisting deficit (mRS Ͼ2) was the strongest predictor for death or disability (baseline mRS odds ratio, 4.1; 95% CI, 2.3 to 7.2), admission to a stroke unit was a valid predictor for survival and independence (odds ratio, 0.4; 95% CI, 0.2 to 0.9). Conclusions-These data from a large, multicenter, nonselected, observational study underscore the "not so benign" prognosis for TIA patients. There is a relevant individual risk of early stroke, death, or disability in TIA patients. Management and treatment strategies are similar for both TIA and acute stroke.

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Cited by 56 publications

References 1 publication

Early Diffusion Weighted MRI as a Negative Predictor for Disabling Stroke After ABCD ² Score Risk Categorization in Transient Ischemic Attack Patients

Early Diffusion Weighted MRI as a Negative Predictor for Disabling Stroke After ABCD ² Score Risk Categorization in Transient Ischemic Attack Patients

Strokes after cardiac surgery: mostly right hemispheric ischemic with mild residual damage

Transient Ischemic Attacks Are More Than “Ministrokes”

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Discussion

Cited by 56 publications

References 1 publication

Early Diffusion Weighted MRI as a Negative Predictor for Disabling Stroke After ABCD 2 Score Risk Categorization in Transient Ischemic Attack Patients

Early Diffusion Weighted MRI as a Negative Predictor for Disabling Stroke After ABCD 2 Score Risk Categorization in Transient Ischemic Attack Patients

Strokes after cardiac surgery: mostly right hemispheric ischemic with mild residual damage

Transient Ischemic Attacks Are More Than “Ministrokes”

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Early Diffusion Weighted MRI as a Negative Predictor for Disabling Stroke After ABCD ² Score Risk Categorization in Transient Ischemic Attack Patients

Early Diffusion Weighted MRI as a Negative Predictor for Disabling Stroke After ABCD ² Score Risk Categorization in Transient Ischemic Attack Patients