MRI findings and stroke risk in TIA patients with different symptom durations

Objective:

To determine the frequency of acute infarction detected by diffusion-weighted imaging (DWI)-MRI and stroke risk in TIA patients with different symptom duration in a population-based study.

Methods:

During a 54-month period (starting November 2007), 3,724 admitted patients (mean age, 67 ± 14 years; 45% women) with transient neurologic symptoms lasting <24 hours from 15 hospitals were included. All patients underwent DWI-MRI during hospitalization.

Results:

Of 3,724 patients, 1,166 showed an acute infarction (32.2%; 95% confidence interval [CI], 30.8%–33.8%) and 88 (2.4%; 95% CI, 1.9%–2.9%) had a stroke during hospitalization (7 days). Stroke risk was higher in patients with tissue-positive DWI than in those with tissue-negative DWI (4.5% vs 1.5%, respectively; p < 0.001). Logistic regression analysis revealed that stroke risk was correlated with positive DWI (odds ratio [OR], 3.1; 95% CI, 2.0–4.8; p < 0.001), atrial fibrillation (OR, 2.1; 95% CI, 1.3–3.5; p = 0.001), and symptom duration <1 hour (OR, 1.5; 95% CI, 1.0–2.4; p = 0.042). Patients with symptoms lasting <1 hour had a lower rate of acute infarction than those with symptoms lasting ≥1 hour (24% vs 36%, respectively; p < 0.001), whereas stroke risk did not differ between the groups (2.8% vs 2.1%, respectively; p = 0.22). Stroke risk was higher after tissue-positive events than tissue-negative ones in patients with symptom duration <1 hour (5.2% vs 2.0%, respectively; p = 0.002) and in those with symptom duration ≥1 hour (4.1% vs 1.1%, respectively; p < 0.001).

Conclusion:

Stroke risk was higher after tissue-positive events than tissue-negative ones in TIA patients with different symptom duration.

http://www.neurology.org/cgi/content/short/80/21/1920?rss=1

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Julio Pereira, MD

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