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Published on: July 28, 2013
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Association Between Duration of Transient Neurological Events and Diffusion-Weighted Brain Lesions
Raed A Joundi1, Amy Y X Yu2, Eric E Smith3
1Division of Neurology, Hamilton Health Sciences McMaster University & Population Health Research Institute Hamilton Ontario Canada.
Journal of the American Heart Association
|January 25, 2023
Summary
Longer focal neurological symptoms increase the risk of diffusion-weighted imaging (DWI) lesions. Nonfocal or mixed symptoms showed no duration-dependent increase in DWI lesions, suggesting different risk factors.
Area of Science:
- Neurology
- Radiology
- Emergency Medicine
Background:
- The link between transient neurological event duration and diffusion-weighted imaging (DWI) lesions, considering symptom type, is not well understood.
- Accurate risk stratification for transient neurological events is crucial for patient management.
Purpose of the Study:
- To investigate the association between the duration of transient neurological events and the presence of DWI lesions.
- To explore how symptom type (focal vs. nonfocal/mixed) modifies this relationship.
Main Methods:
- A substudy of the Spectrometry for Transient Ischemic Attack Rapid Assessment (SpecTRA) cohort included 658 patients with resolved symptoms.
- Logistic regression analyzed the association between symptom duration and DWI lesions (MRI within 7 days), adjusting for covariates.
- Interaction between symptom duration and symptom type was assessed.
Main Results:
- A diffusion-weighted imaging (DWI) lesion was present in 35.1% of patients.
- A significant interaction was found between symptom duration and symptom type.
- For focal-only symptoms, DWI lesion probability increased with duration up to 24 hours (40%-80%), notably in women.
- For nonfocal/mixed symptoms, DWI lesion probability was ≈35%, higher in men, and not duration-dependent.
Conclusions:
- Increased duration of focal neurological deficits is linked to a higher likelihood of DWI lesions.
- Nonfocal or mixed symptoms showed a consistent, non-duration-dependent probability of DWI lesions (≈35%).
- Findings may aid in refining risk stratification for transient neurological events.
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