Abstract
We read, with interest, the article by Hurford et al.1 that focused on the long-term prognostic value of “tissue-based” definitions of TIA and minor stroke. Diffusion-weighted imaging (DWI)–positive lesions are associated with longer duration of ischemia and are also time dependent.2 Accordingly, there was a high risk of a false negative rate because of the delayed scan time in this study. The differences in the time interval of event to MRI between the DWI-positive and DWI-negative groups might illustrate this point as well, which would inevitably increase statistical discrepancy. Moreover, DWI lesions can be transient, especially if normal blood flow is restored by pharmacologic mechanisms, such as thrombolysis or antithrombotic therapy.3 Consequently, therapeutic measures should be also be taken into account.
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