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PT  - JOURNAL ARTICLE
AU  - Ssi-Yan-Kai, G.
AU  - Nasr, N.
AU  - Faury, A.
AU  - Catalaa, I.
AU  - Cognard, C.
AU  - Larrue, V.
AU  - Bonneville, F.
TI  - Intracranial Artery Stenosis or Occlusion Predicts Ischemic Recurrence after Transient Ischemic Attack
AID  - 10.3174/ajnr.A3144
DP  - 2013 Jan 01
TA  - American Journal of Neuroradiology
PG  - 185--190
VI  - 34
IP  - 1
4099  - http://www.ajnr.org/content/34/1/185.short
4100  - http://www.ajnr.org/content/34/1/185.full
SO  - Am. J. Neuroradiol.2013 Jan 01; 34
AB  - BACKGROUND AND PURPOSE: Patterns of DWI findings that predict recurrent ischemic events after TIA are well-established, but similar assessments of intracranial MRA findings are not available. We sought to determine the imaging characteristics of MRA that are predictive of early recurrent stroke/TIA in patients with TIA. MATERIALS AND METHODS: We performed a retrospective analysis of 129 consecutive patients with a clinical diagnosis of TIA in whom MR imaging was done within 24 hours of symptom onset. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of &amp;gt;50% stenosis or occlusion of symptomatic intracranial arteries for recurrent stroke/TIA at 7 days after TIA. We used logistic regression analysis to adjust for the clinical ABCD2 score. We performed this analysis for symptomatic steno-occlusive lesions at any site and symptomatic steno-occlusive lesions on proximal large intracranial arteries (internal carotid artery, vertebral artery, basilar artery, and circle of Willis). RESULTS: Forty-two (32.5%) patients had acute ischemic lesions on DWI; 16 (12.4%) had significant MRA lesions, of which 11 (8.5%) were on proximal vessels. Nine patients had early recurrence (TIA, 7; minor stroke, 2). Only patients with proximal MRA lesions were at higher risk of early recurrence independent of the ABCD2 score (adjusted odds ratio, 5.5; 95% confidence interval, 1.1–27.8; P = .04). CONCLUSIONS: Proximal lesions of cerebral arteries seen on MRA were predictive of recurrent stroke/TIA at 7 days. These findings suggest that MRA could be used to improve the selection of patients with TIA at high risk of early recurrent stroke/TIA. ABCD2age, blood pressure, clinical deficit, duration, diabetesEKGelectrocardiogramMIPmaximum intensity projectionTOFtime of flight