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Diffusion-weighted imaging in transient neurological attacks.

Frank G van Rooij1, Sarah E Vermeer2, Bozena M Góraj3,4

  • 1Department of Neurology, Center for Neuroscience, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands.

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|October 9, 2015
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Summary
This summary is machine-generated.

Diagnosing transient ischemic attacks (TIAs) is challenging. Early MRI using diffusion-weighted imaging (DWI) can detect acute ischemia in patients with transient neurological attacks (TNAs), improving diagnostic accuracy.

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Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Transient ischemic attack (TIA) diagnosis is often difficult.
  • Transient neurological attacks (TNAs) with atypical or nonfocal symptoms are common.
  • Diffusion-weighted imaging (DWI) detects acute cerebral ischemia in some TIA patients.

Purpose of the Study:

  • To evaluate the diagnostic utility of DWI in patients with clinically diagnosed TNAs.
  • To assess the accuracy of clinical diagnosis for TIA and TNA.
  • To determine the added value of early magnetic resonance imaging (MRI) for atypical neurological events.

Main Methods:

  • Patients with clinically diagnosed TNA underwent diffusion-weighted imaging (DWI).
  • Experienced stroke neurologists provided clinical diagnoses.
  • Comparison of clinical diagnosis with DWI findings for acute cerebral ischemia.

Main Results:

  • DWI revealed acute ischemia in 23% of patients diagnosed with TNA.
  • This finding suggests potential misdiagnosis in clinically evaluated TIA/TNA cases.
  • Early MRI with DWI shows promise in identifying ischemia in TNA patients.

Conclusions:

  • Clinical diagnosis of TIA and TNA may lack accuracy.
  • DWI is valuable for detecting acute ischemia in patients with transient neurological symptoms.
  • Early MRI is recommended for patients experiencing acute onset of atypical or nonfocal neurological symptoms.