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A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia

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Transient Ischemic Attack: Which Determines Diffusion-Weighted Image Positivity?

Yosuke Aiba¹, Ryuji Sakakibara¹, Fuyuki Tateno¹

¹Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association

|October 5, 2019

Summary

This summary is machine-generated.

Diffusion-weighted imaging (DWI) positivity in transient ischemic attack (TIA) patients, found in 54% of cases, is linked to higher plasma osmolarity and may predict stroke recurrence.

Keywords:

Transient ischemic attack diffusion-weighted image osmolarity prognosis stroke

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Area of Science:

Neurology
Radiology
Internal Medicine

Background:

Diffusion-weighted imaging (DWI) on magnetic resonance imaging (MRI) detects lesions in up to 50% of transient ischemic attack (TIA) patients.
Factors influencing DWI positivity in TIA patients are not well understood.
Understanding these factors is crucial for predicting stroke risk and patient outcomes.

Purpose of the Study:

To identify factors associated with DWI positivity in patients experiencing TIA.
To investigate the relationship between DWI positivity and clinical/laboratory parameters.
To explore the predictive value of DWI positivity for stroke recurrence.

Main Methods:

A cohort of 257 stroke patients was analyzed, with a focus on 24 TIA patients (9.3%).
All TIA patients underwent 1.5T MRI, including DWI.
Parameters assessed included ABCD2 score, smoking, blood profile, HbA1C, dyslipidemia, coagulation factors, imaging, and clinical symptoms.

Main Results:

54% (13 of 24) of TIA patients were DWI positive.
Higher plasma osmolarity was significantly associated with DWI positivity (305.3 mOsm/l in positive vs. 301.3 mOsm/l in negative cases; P=.0064).
DWI positive cases showed a trend towards more frequent recurrence (23.1%) compared to DWI negative cases (9.0%), though not statistically significant.

Conclusions:

DWI positivity was observed in 54% of TIA patients in this study.
Initial dehydration, indicated by higher plasma osmolarity, is closely associated with DWI positivity in TIA.
DWI positivity may serve as a potential predictor for stroke recurrence in TIA patients.