The value of diffusion-weighted imaging in prediction of outcome of transient ischemic attacks

Abstract

Objective The aim of the study was to study the clinical significance of diffusion-MRI in the prediction of outcome of transient ischemic attacks (TIAs) and its relation to the risk factors and TIA clinical presentations. Background Diffusion-weighted imaging (DWI) observations in TIA patients led to the proposal for a new definition of TIA, which is called the 'tissue-based' TIA definition, so that patients with clinical symptoms of focal brain with acute DWI-lesions, irrespective of the neurological signs duration, had a stroke rather than TIA. Patients and methods The participants in this study were classified into two groups: patient group (group I) and control group (group II) ( n = 20) of normal individuals. The patients in group I ( n = 35) were those who had had recent TIAs for the first time for whom an initial brain DWI was performed within 48 h after the onset of TIA and a follow-up one 3 months later for those with initial positive DWI. Results Initial DWI lesions were detected in nine (25.7%) patients; it was found that those with TIA duration 1 h or more, with mainly AF or carotid artery stenosis more than 50% and presenting clinically with aphasia or motor manifestations, had lesions on DWI. Conclusion TIA patients with duration of symptoms 1 h or more, atrial fibrillation or carotid artery stenosis more than 50% risk factors, and presenting clinically with motor deficits or aphasia had DWI positivity and thus an increased risk of developing stroke.