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Perfusion computed tomography in transient ischemic attack.

Shyam Prabhakaran1, Sohal K Patel, Jordan Samuels

  • 1Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA. shyam_prabhakaran@rush.edu

Archives of Neurology
|January 12, 2011
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Summary

Perfusion computed tomography (PCT) revealed abnormalities in one-third of patients experiencing transient ischemic attack (TIA). These perfusion abnormalities may indicate a higher risk for early deterioration after TIA.

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Diffusion- and perfusion-weighted imaging are established for transient ischemic attack (TIA) assessment.
  • Perfusion computed tomography (PCT) data in TIA patients remain limited.

Purpose of the Study:

  • To determine the incidence of PCT abnormalities in anterior circulation TIA.
  • To identify factors associated with PCT abnormalities in TIA patients.

Main Methods:

  • Retrospective study of 65 patients with anterior circulation TIA who underwent PCT.
  • Automated software defined perfusion abnormality based on mean transit time and cerebral blood volume.
  • Demographic, risk factor, clinical, and radiographic data were analyzed.

Main Results:

  • 33.8% of patients with TIA exhibited focal perfusion abnormalities on PCT.
  • Motor symptoms, multiple TIA episodes, significant ipsilateral arterial stenosis/occlusion, and large-artery atherosclerosis were linked to perfusion abnormalities.
  • Patients with perfusion abnormalities had a higher incidence of subsequent in-hospital events.

Conclusions:

  • Acutely performed PCT identifies perfusion abnormalities in approximately one-third of hemispheric TIA cases.
  • PCT abnormalities may serve as a marker for increased risk of early deterioration.
  • Further research is warranted to validate these findings and their clinical implications.