High Rate of Magnetic Resonance Imaging Stroke Recurrence in Cryptogenic Transient Ischemic Attack and Minor Stroke Patients
| Autor: | Shiel K. Patel, Mohammed A. Almekhlafi, Andrew M. Demchuk, Simerpreet Bal, Jayesh Modi, Shelagh B. Coutts |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Stroke recurrence Radiography Population Risk Assessment Severity of Illness Index Predictive Value of Tests Recurrence Risk Factors medicine Humans Prospective Studies education Stroke Aged Advanced and Specialized Nursing High rate education.field_of_study medicine.diagnostic_test business.industry Stroke scale Minor stroke Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Ischemic Attack Transient Physical therapy Female Neurology (clinical) Radiology Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Stroke. 43:3387-3388 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/strokeaha.112.671172 |
| Popis: | Background and Purpose— Cryptogenic stroke is common in patients with transient ischemic attack (TIA) and minor stroke. It is likely that the imaging recurrence risk is higher than the clinical recurrence rate. We sought to determine the rate of clinical and radiographic stroke recurrence in a population of cryptogenic TIA and minor stroke. Methods— Patients with TIA/minor stroke (National Institutes of Health Stroke Scale score ≤3) were prospectively enrolled and imaged within 24 hours of symptom onset as part of 2 cohorts. Patients were assessed at 3 months to document any clinical recurrence and underwent repeat magnetic resonance imaging (MRI) at either 30 or 90 days. Stroke mechanism was categorized as cryptogenic after standard etiologic work-up was completed and was negative. Follow-up MRI was assessed for any new lesions in comparison with baseline imaging. Results— Three hundred thirty-three of 693 (48%) patients had cryptogenic stroke. Of these cryptogenic patients, 207 (62%) had follow-up imaging. At 30-day MRI follow-up, 6.6% (5/76) had new lesions (3 in a remote arterial territory). At 90-day MRI follow-up, 14.5% (19/131) had new lesions (9 in a remote arterial territory). Clinical recurrent stroke was seen in 1.2% (4/333) of patients within 90 days. Conclusions— Cryptogenic etiology is common in a TIA/minor stroke population. This population shows a high rate of silent radiographic recurrence, suggesting active disease. Use of MRI as a surrogate marker of disease activity is 1 potential way of assessing efficacy of new treatments in this population with reduced sample size. |
| Databáze: | OpenAIRE |
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