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  • Title: Diffusion-weighted imaging-negative patients with transient ischemic attack are at risk of recurrent transient events.
    Author: Boulanger JM, Coutts SB, Eliasziw M, Subramaniam S, Scott J, Demchuk AM.
    Journal: Stroke; 2007 Aug; 38(8):2367-9. PubMed ID: 17615367.
    Abstract:
    BACKGROUND AND PURPOSE: Among patients presenting with a transient ischemic attack (TIA), some clinical features predispose to recurrent TIA, whereas others predispose to subsequent strokes. We assessed the implication of negative diffusion-weighted imaging on a baseline MRI in predicting subsequent TIA. METHODS: We prospectively studied patients presenting in the emergency department within 12 hours of a TIA (motor or speech). All patients had a MRI within 24 hours of the index event. The primary outcome was TIA within 1 year of study entry. The 1-year risk of stroke was also evaluated. RESULTS: A total of 85 patients had a MRI, among which 35 patients (41.2%) had a diffusion-weighted imaging lesion. The mean time from symptom onset to MRI was 12.1 hours. Patients without a diffusion-weighted imaging lesion on baseline MRI were 4.6 times (27.4% versus 5.9%; P<0.05) more likely to have a subsequent TIA at 1 year than patients with a diffusion-weighted imaging lesion, but 4.3 times (2.1% versus 9.1%; P=0.19) less likely to have a subsequent stroke. CONCLUSIONS: The absence of a diffusion-weighted imaging lesion on the baseline scan predicts recurrent transient events rather than stroke.
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