ABCD(2) as a screening tool for cerebral infarction on stroke MRI?

Area of Science:

• Neurology
• Radiology
• Emergency Medicine

Background:

• The new transient ischemic attack (TIA) definition requires MRI to exclude infarction.
• Limited resources necessitate alternative tools to MRI for predicting infarction.
• The ABCD(2) risk score is proposed as a potential screening tool for diffusion-weighted imaging (DWI) lesions.

Purpose of the Study:

• To evaluate the ABCD(2) risk score's validity in screening for DWI lesions in TIA patients.
• To determine if the ABCD(2) score can predict acute ischemic changes on MRI.

Main Methods:

• Prospective enrollment of TIA patients in an observational MRI study.
• Calculation of ABCD(2) scores and recording of sociodemographics and risk factors.
• Acute and follow-up stroke MRI including DWI sequences were performed.

Main Results:

• 127 TIA patients were analyzed; 45 showed acute ischemic lesions on DWI.
• Median ABCD(2) scores were 4 for DWI-negative and 5 for DWI-positive patients.
• Unilateral weakness, symptom duration, and smoking were predictive in univariate analysis; unilateral weakness remained significant in multivariate analysis.

Conclusions:

• A high-risk ABCD(2) score, particularly due to hemiparesis, correlates with DWI lesions.
• The ABCD(2) score alone is insufficient for reliably differentiating TIA events with and without MRI-detected infarction.
• Further research is needed to refine screening tools for TIA patients.