Risk assessment of cerebral infarction on 578 cases of transient ischemic attack

Abstract

Objective To investigate the risk of cerebral infarction on pat ients with transient ischemicattack (TIA) by combining ABCD2 score and three imaging methods.Methods Five hundred and seventy-eight patients with TIA visiting our hospital from January 2007 to December 2011 were assessed for the risk of cerebral infarction after TIA by ABCD2 score method,magnetic resonance diffusion weighted imaging (DWI),magnetic resonance angiography (MRA) and carotid artery color Doppler imaging (CDFI).Cases were followed up on 2 d,7 d and 30 d for incidence of cerebral infarction.Results Cerebral infarction occurred in 37 cases (6.40％),47 cases ( 8.13％ ) and 61 cases ( 10.55％ ) on day 2,day 7 and day 30.The occurrence of cerebral infarction after TIA in high risk group (35 cases ) by single ABCD2 score was found in 15 cases (42.86％ ),18 cases (51.43％) and 21 cases (60.00％) on day 2,day 7 and day 30.Twenty-eight cases (54.90％),31cases (60.78％ ),and 38 cases (74.51％ ) of patients after TIA with ABCD2 ＞ 3 and DWI positivity (51cases) suffered cerebral infarction on day 2,day 7 and day 30.Cerebral infarction occurred in 22 cases (61.11％),24 cases (66.67％ ) and 30 cases (83.33％) of patients with ABCD2 ＞ 3 points and cerebral artery stenosis (36 cases) on day 2,day 7 and day 30 after TIA.The occurrence of cerebral infarction after TIA on day 2,day 7 and day 30 were in 21 cases ( 60.00％ ),23 cases ( 65.71％ ),28 cases ( 80.00％ ) of the patients with ABCD2 ＞ 3 points and the carotid artery atheroma-caused bureaucratic stenosis (35 cases).There were no significant difference in the value of three methods to assess the risk of cerebral infarction in high-risk TIA groups (P ＞ 0.05).Conclusion TIA patients can progress to cerebral infarction in the short term.There are some predictive value by ABCD2 score from 2 to 30 days for cerebral infarction occurring after TIA,but it is only a simple clinical assessment method.ABCD2 score ＞ 3 points must be combined with DWI,MRA,and other tests in high-risk patients to identify the risk of cerebral infarction,thus improving the accuracy of the prediction.The combined evaluation of TIA patients will help the clinicians give better treatment and decision to this group of patients Key words: Transient cerebral ischemic attack; Cerebral infarction; ABCD2 score; Magnetic resonance angiography; Magnetic resonance diffusion-weighted imaging