Lesions visualized by contrast-enhanced magnetic resonance imaging in transient ischemic attacks

Kimura, Kazumi; Minematsu, Kazuo; Wada, Keita; Yonemura, Kensuke; Yasaka, Masahiro; Yamaguchi, Takenori

doi:10.1016/s0022-510x(99)00305-6

Cited by 23 publications

(13 citation statements)

References 14 publications

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“…All studies used the TIA definition of "ischemic symptoms lasting Ͻ24 hours." Two studies excluded posterior circulation events, 16,29 and one study excluded anterior circulation events. 20 Four studies excluded patients if the delay to scan was above a certain threshold (6 hours, 15 24 hours, 16 3 days, 7 and 14 days 18 ).…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of Associations Between the Presence of Acute Ischemic Lesions on Diffusion-Weighted Imaging and Clinical Predictors of Early Stroke Risk After Transient Ischemic Attack

Redgrave

Coutts

Schulz

et al. 2007

Stroke

162

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Background and Purpose-Early risk of stroke after a transient ischemic attack can be reliably predicted with risk scores based on clinical features of the patient and of the ischemic event, but it is unclear how these features correlate with findings on brain imaging. Methods-We performed a systematic review of the literature and identified all previous studies which reported patient characteristics and the nature of transient ischemic attack symptoms in relation to appearances on diffusion-weighted imaging (DWI). We then performed a meta-analysis of the associations between the components of the risk scores and positive DWI. Authors were contacted for additional unpublished data. Results-Nineteen studies were identified by the systematic review, and additional unpublished data were obtained from 11 of these studies. On meta-analysis, several components of the risk scores were associated with positive DWI, including symptom duration Ն60

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Section: Resultsmentioning

confidence: 99%

Systematic Review of Associations Between the Presence of Acute Ischemic Lesions on Diffusion-Weighted Imaging and Clinical Predictors of Early Stroke Risk After Transient Ischemic Attack

Redgrave

Coutts

Schulz

et al. 2007

Stroke

162

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“…Some studies [11,13], but not all [16,19], found a higher frequency of DWI lesions in TIA with particular causes such as emboligenic cardiac disease or carotid stenosis. We failed to demonstrate such a significant association between DWI lesion and identifiable TIA cause.…”

Section: Discussionmentioning

confidence: 99%

“…The drawback of this definition, which became apparent as early as the computed tomography (CT) era, have been demonstrated even more pointedly by recent magnetic resonance imaging (MRI) investigations [2,3]. Among patients meeting clinical criteria for TIA, 2-48% demonstrate neuroanatomically relevant infarcts on standard CT [4][5][6][7][8][9] or conventional MRI [10,11]. As for acute stroke patients [12], recent studies have demonstrated that diffusion MRI provides a more sensitive and specific evaluation of ischaemic insult in patients with TIA than standard CT and MRI studies [2,3].…”

Section: Introductionmentioning

confidence: 99%

Diffusion-weighted MR imaging in transient ischaemic attacks

Lamy

Oppenheim²,

Calvet

et al. 2006

Eur Radiol

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The purpose of this study was to determine frequency and the characteristics of diffusion-weighted imaging (DWI) abnormalities in patients with transient ischaemic attack (TIA). We analysed data of 98 consecutive patients (mean age: 60.6+/-15.4 years, 56 men) admitted between January 2003 and April 2004 for TIA. Age, gender, symptom type and duration, delay from onset to magnetic resonance imaging (MRI), probable or possible TIA and cause of TIA were compared in patients with (DWI+) and without (DWI-) lesions on DWI. Volume and apparent diffusion coefficient (ADC) values of DWI lesions were computed. DWI revealed ischaemic lesions in 34 patients (34.7%). Lesions were small (mean volume: 1.9 cm(3)+/-3.3), and ADC was moderately decreased (mean ADC ratio: 79.5%). The diagnosis of TIA was considered as probable in all DWI+ patients. A multiple logistic regression model demonstrated that TIA duration greater than or equal to 60 min (OR, 7.6; 95% CI, 2.3-25.7), aphasia (OR, 9.2; 95% CI, 2.7-31.4) and motor deficit (OR, 5.1; 95% CI, 1.5-17.8) were independent predictors of DWI lesions. Prolonged TIA duration, aphasia and motor deficits are associated with DWI lesions. More than half of TIA patients with symptoms lasting more than 60 min have DWI lesions.

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“…Other studies have found an association between higher brain dysfunction and presence of DWI lesions in patients with transient symptoms [24,30,31]. It is likely that the disturbances of these functions were caused by ischemia affecting cortical areas.…”

Section: Discussionmentioning

confidence: 90%

Diffusion-Weighted Lesions in Stroke Patients with Transient Symptoms - Where Are They Located?

Kvistad¹,

Logallo²,

Thomassen³

et al. 2014

Cerebrovasc Dis

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Background: MR diffusion-weighted imaging (DWI) has revolutionized neuroimaging and contributed to a tissue-based redefinition of transient ischemic attack (TIA). Stroke patients with DWI lesions may have neurological symptoms that resolve completely within 24 h, suggesting successful vessel recanalization. Prior studies of stroke patients with transient symptoms have not found any predilection for DWI lesions in any specific territory. Other studies have, however, reported an association between higher brain dysfunction and presence of DWI lesions in patients with transient ischemic symptoms, suggesting a high rate of cortical affection in these patients. We sought to see whether DWI location in stroke patients with transient symptoms <24 h differed from those with persistent symptoms ≥24 h. We hypothesized an association between transient symptoms <24 h and cortical DWI lesion localization due to a possible higher rate of vessel recanalization in patients with transient symptoms causing distal cortical infarctions. Methods: Ischemic stroke patients examined with DWI and admitted within 24 h after symptom onset between February 2006 and November 2013 were prospectively registered in a database (The Bergen NORSTROKE Registry). Based on neurological examination 24 h after admission, patients were classified as having either transient symptoms <24 h (DWI <24) or persistent symptoms ≥24 h (DWI ≥24). DWI lesions were classified into different groups depending on lesion location: cortical lesions, confined to the supratentorial cortex; large subcortical lesions, located in the hemispheric white matter, basal ganglia, internal capsule, thalamus or corona radiate with a diameter ≥15 mm; lacunar lesions, located in the same territory as large subcortical lesions with a diameter <15 mm; mixed cortical-subcortical lesions, located in both supratentorial cortex and subcortex; cerebellar lesions, confined to the cerebellum; brain stem lesions, confined to the brain stem; multiple locations, located in more than one of the above defined areas. Results: A total of 142 ischemic stroke patients had DWI <24 and 830 DWI ≥24. Cortical DWI location was more frequent in patients with DWI <24 (54.2% vs. 29.5%, p < 0.001), while proportions of mixed cortical-subcortical lesions (13.4% vs. 26.5%, p = 0.001) and lesions with multiple locations (5.6% vs. 11.1%, p = 0.048) were less frequent as compared to DWI ≥24. Cortical DWI location was independently associated with DWI <24 when adjusted for confounders in multiple regression analyses (OR 1.89, 95% CI 1.28-2.81, p = 0.001). Conclusion: Cortical DWI location was independently associated with transient stroke symptoms <24 h. This may be explained by vessel recanalization, resulting in upstream transportation of remaining particles and distal cortical lesions.

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Lesions visualized by contrast-enhanced magnetic resonance imaging in transient ischemic attacks

Cited by 23 publications

References 14 publications

Systematic Review of Associations Between the Presence of Acute Ischemic Lesions on Diffusion-Weighted Imaging and Clinical Predictors of Early Stroke Risk After Transient Ischemic Attack

Systematic Review of Associations Between the Presence of Acute Ischemic Lesions on Diffusion-Weighted Imaging and Clinical Predictors of Early Stroke Risk After Transient Ischemic Attack

Diffusion-weighted MR imaging in transient ischaemic attacks

Diffusion-Weighted Lesions in Stroke Patients with Transient Symptoms - Where Are They Located?

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