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Are CT infarcts a separate risk factor in patients with transient cerebral ischaemic episodes?
E Meagher1, P A Grace, D Bouchier-Hayes
1Department of Surgery, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin.
Insights
Asymptomatic cerebral infarcts on CT scans may indicate good collateral circulation in patients with transient ischemic attacks (TIAs). Evaluating infarcts and collateral flow is crucial for predicting outcomes in TIA patients.
Area of Science:
- Neurology
- Radiology
- Cerebrovascular Disease
Background:
- Cerebral infarcts detected by CT scans are observed in patients experiencing transient ischemic episodes.
- The brain's collateral circulation may limit neuronal damage in asymptomatic infarcts.
Purpose of the Study:
- To test the hypothesis that asymptomatic CT cerebral infarcts reflect the brain's collateral circulation capacity.
- To evaluate the prognostic significance of CT infarcts and collateral cerebral circulation in TIA patients.
Main Methods:
- A study involving 50 patients who underwent both CT scanning and cerebral angiography.
- Assessment of CT for cerebral infarcts and cerebral angiography for collateral circulation reserve capacity.
Main Results:
- 15 out of 50 patients had CT evidence of 17 infarcts.
- 10 of 14 patients (71%) with diminished collateral reserve capacity showed CT infarcts, compared to 5 of 36 patients (14%) without diminished reserve.
Conclusions:
- Diminished collateral circulation is associated with a higher incidence of CT-detected cerebral infarcts in TIA patients.
- CT infarcts and collateral cerebral circulation are important prognostic factors in managing TIA patients.
Abstract:
CT cerebral infarcts have been reported in a number of studies of patients with transient ischaemic episodes. The hypothesis that these asignomatic infarcts, i.e. without associated clinical neurological deficit reflect the ability of the brain to limit the extent of neuronal damage through its collateral circulation was tested in 50 patients undergoing both CT scanning and cerebral angiography. Out of 50 patients there were 15 patients with a total of 17 infarcts on CT scan. Fourteen of 50 patients had evidence of diminished collateral reserve capacity on cerebral angiography. Ten of these 14 patients (71%) had CT evidence of infarction, in contrast to an incidence of five out of 36 patients (14%) without evidence of diminished collateral reserve. These results indicate that CT infarcts and collateral cerebral circulation must be evaluated as prognostic factors in patients with T.I.A.s.