| Clinical Significance of Cytotoxic Abnormalities Revealed by Diffusion Weighted Image in Transient Ischemic Attack Patients |
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Sung Hoon Kim1 , Min Ho Kong1,2 , Se Youn Jang1,2 , Jung Hee Kim1 , Tai Hwan Park2 , Tae Gon Kim3 , Dong Soo Kang1 , Kwan Young Song1,2 |
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Departments of 1Neurosurgery, 2Stroke Center, Seoul Medical Center, Seoul,
3Departments of Neurosurgery, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, Korea |
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| Abstract |
Objective
Transient symptoms with infarction (TSI) have known to be defined as transient neurologic symptoms associated with diffusion-weighted image (DWI) detected abnormalities but has not been systemically investigated in patients with TSI.
Methods
Retrospective analysis was performed on 149 consecutive patients presenting with acute focal neurologic symptoms lasting less than 24 hours between Jan. 2012 and May 2012. We compared the clinical background of the patients between both TIA and TSI groups using DWI within 3 days of symptom onset. We examined the relationship between DWI-detected findings and patients’ clinical characteristics.
Results
DWI-detected abnormalities were presented in 20 (13.4%) patients out of 149 patients with transient ischemic symptoms. Prolonged TIA duration (>60 minutes), hemiparesis, previous history of TIA, atrial fibrillation, and the presence of moderate to severe stenosis of ICA were observed more frequently in the group with abnormalities on DWI than in the group without abnormalities on DWI (p<0.05). Recurrence of TIA except stroke recurrence was significantly correlated with abnormalities on DWI rather than without abnormalities on DWI. Especially, the recurrence of cerebral ischemia or ischemic stroke in the group of ABCD >4 and DWI (+) were significantly higher than the one of the group of ABCD ≤4 and DWI (-).
Conclusion
These results demonstrate that DWI abnormalities in TIA are different from TIA without DWI abnormalities and its risk factors are needed to be more precisely evaluated and aggressively managed. In addition, the abnormality of DWI in combination with higher ABCD scores may help to predict of the recurrence after transient ischemic attack. |
| Key Words:
Transient ischemic attackㆍDiffusion-weighted imaging |
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