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Head computed tomography findings predict short-term stroke risk after transient ischemic attack.
Vanja C Douglas1, Clarissa M Johnston, Jacob Elkins
1Department of Neurology, University of California, San Francisco 94143-0114, USA.
Stroke
|November 15, 2003
Summary
Head CT scans in patients with transient ischemic attack (TIA) can identify new infarcts. Finding a new infarct on head CT is linked to a higher risk of subsequent stroke, supporting its prognostic value.
Area of Science:
- Neurology
- Radiology
- Emergency Medicine
Background:
- Current guidelines suggest head CT for transient ischemic attack (TIA) evaluation.
- Limited data exist to support the routine use of head CT in TIA patients.
Purpose of the Study:
- To evaluate the prognostic value of head CT in patients diagnosed with TIA.
- To determine if head CT findings predict short-term stroke risk after TIA.
Main Methods:
- Retrospective study of 322 TIA patients from 16 emergency departments.
- Head CT findings (new infarct, old infarct, white-matter disease, atrophy, calcification, nonischemic lesions) were abstracted.
- Patients were followed for 90 days for subsequent stroke events.
Main Results:
- Head CT was performed in 67% of TIA patients.
- New infarcts were identified in 4% of patients; nonischemic causes in 1.2%.
- Patients with new infarcts on head CT had a significantly higher risk of stroke (OR 4.06, P=0.028).
Conclusions:
- Head CT findings of new infarcts in TIA patients are associated with increased short-term stroke risk.
- Head CT demonstrates prognostic value in TIA evaluation, potentially justifying its use.