Refinement of Imaging Predictors of Recurrent Events following Transient Ischemic Attack and Minor Stroke
| Autor: | Shelagh B. Coutts, Shiel K. Patel, Mayank Goyal, Myles Horton, Michael D. Hill, Jayesh Modi, Andrew M. Demchuk |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
Time Factors Epidemiology lcsh:Medicine 030204 cardiovascular system & hematology Bioinformatics Brain Ischemia Diagnostic Radiology 0302 clinical medicine Occlusion Medicine lcsh:Science Stroke Aged 80 and over education.field_of_study Multidisciplinary medicine.diagnostic_test Middle Aged Magnetic Resonance Imaging White Matter 3. Good health Neurology Predictive value of tests Cardiology Female Radiology Research Article Adult medicine.medical_specialty Cerebrovascular Diseases Population Neuroimaging 03 medical and health sciences Computed Tomography Predictive Value of Tests Internal medicine Humans Transient Ischemic Attacks cardiovascular diseases education Biology Aged Ischemic Stroke Population Biology business.industry lcsh:R Magnetic resonance imaging medicine.disease Clinical trial Stenosis lcsh:Q Tomography X-Ray Computed business 030217 neurology & neurosurgery Diffusion MRI |
| Zdroj: | PLoS ONE, Vol 8, Iss 6, p e65752 (2013) PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | Background TIA and minor stroke have a high risk of recurrent stroke. Abnormalities on CT/CTA and MRI predict recurrent events in TIA and minor stroke. However there are many other imaging abnormalities that could potentially predict outcome that have not been assessed in this population. Also the definition of recurrent events used includes deterioration due to stroke progression or recurrent stroke and whether imaging is either of these is not known. Aims To improve upon the clinical, CT/CTA and MRI parameters that predict recurrent events after TIA and minor stroke by assessing further imaging parameters. Secondary aim was to explore predictors of stroke progression versus recurrent stroke. Methods 510 consecutive TIA and minor stroke patients had CT/CTA and most had MRI. Primary outcome was recurrent events (stroke progression or recurrent stroke) within 90 days. Further imaging parameters were assessed for prediction of recurrent events (combined outcome of stroke progression and recurrent stroke). We also explored predictors of symptom progression versus recurrence individually. Results 36 recurrent events (36/510, 7.1% (95% CI: 5.0-9.6)) including 19 progression and 17 recurrent strokes. On CT/CTA: white matter disease, prior stroke, aortic arch focal plaque≥4 mm, or intraluminal thrombus did not predict recurrent events (progression or recurrent stroke). On MRI: white matter disease, prior stroke, and microbleeds did not predict recurrent events. Parameters predicting the individual outcome of symptom progression included: ongoing symptoms at initial assessment, symptom fluctuation, intracranial occlusion, intracranial occlusion or stenosis, and the CT/CTA metric. No parameter was strongly predictive of a distinct recurrent stroke. Conclusions There was no imaging parameter that could improve upon our original CT/CTA or MRI metrics to predict the combined outcome of stroke progression or a recurrent stroke after TIA and minor stroke. We are better at using imaging to predict stroke progression rather than recurrent stroke. |
| Databáze: | OpenAIRE |
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