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Author Spotlight: Assessing Ischemic Stroke Damage Through Middle Cerebral Artery Occlusion Model
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Author Spotlight: Assessing Ischemic Stroke Damage Through Middle Cerebral Artery Occlusion Model

Published on: August 11, 2023

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MRI Profile and Collateral Status in Patients with a Transient Ischemic Attack and an Intracranial Artery Occlusion

Elodie Ong1, Omer Eker2,3, Leila Chamard2

  • 1Stroke Department, Neurological Hospital, Pierre Wertheimer, Hospices Civils de Lyon, Bron Cedex, France.

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|September 14, 2018
PubMed
Abstract

Insights

Transient ischemic attacks (TIAs) can indicate intracranial artery occlusion. Acute magnetic resonance imaging (MRI) helps identify these occlusions and guide reperfusion therapy decisions.

Area of Science:

  • Neurology
  • Radiology
  • Vascular Medicine

Background:

  • Transient ischemic attacks (TIAs) can rarely be the presenting symptom of acute intracranial artery occlusion.
  • Early identification of intracranial artery occlusion is crucial for timely reperfusion therapy.

Purpose of the Study:

  • To analyze acute magnetic resonance imaging (MRI) patterns in patients presenting with TIA and intracranial artery occlusion.
  • To evaluate the early outcomes of reperfusion therapy in these specific patient cases.

Main Methods:

  • Retrospective analysis of clinical and imaging data from a comprehensive stroke center registry.
  • Classification of MRI findings into two patterns: Pattern A (full mismatch) and Pattern B (large mismatch).
  • Utilized MRI-derived collateral flow maps and assessed treatment with recombinant tissue plasminogen activator (rtPA) alone or with mechanical thrombectomy.

Main Results:

  • Out of 1,019 patients treated with rtPA, 14 experienced TIAs preceding acute intracranial artery occlusion.
  • All 11 patients with perfusion imaging had arterial occlusion, with 3 (21%) having proximal occlusions.
  • Good collateral flow was observed in 10 patients, leading to favorable outcomes (median modified Rankin Scale of 0 at 3 months).

Conclusions:

  • TIAs can be an uncommon but significant indicator of acute intracranial artery occlusion.
  • Acute MRI, including perfusion imaging and collateral assessment, is valuable in guiding therapeutic decisions for stroke patients.
Keywords:
MRITIAsarterial occlusioncollateral flow

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