The role of urgent imaging in the diagnosis and management of patients with TIA and minor stroke

Abstract

The diagnosis of patients with transient ischemic attack and minor stroke is challenging as patients have minimal or no neurological deficits related to their ischemic event on their clinical examination. Multiple clinical factors have been used in triaging these patients into high- and low-risk categories based on the estimated risk of having a recurrent ischemic event. However, the ability of clinical factors in isolation in predicting future ischemic events remains poor. The addition of urgent neuroimaging has substantially improved the diagnostic certainty and the accuracy of outcome prediction in this patient population. In this article, we briefly discuss the different forms of subsequent ischemic events that may occur in patients with transient ischemic attack and minor stroke. We review the role of different forms of parenchymal and vascular neuroimaging in the acute setting in establishing the correct diagnosis and predicting both radiographic and clinical outcomes in this patient population.