Document Detail


MRI findings may predict early neurologic deterioration in acute minor stroke or transient ischemic attack due to intracranial atherosclerosis.
MedLine Citation:
PMID:  20616559     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients with intracranial atherosclerosis (ICAS) are at high risk of early recurrence or neurologic deterioration. Although minor stroke and transient ischemic attack (TIA) seem benign, their occurrence in patients with ICAS may lead to early neurological deterioration (END). We aimed to identify factors associated with END in ICAS patients presenting with acute minor stroke or TIA, with a focus on early MRI findings.
METHODS: This was a retrospective analysis of consecutive patients with acute minor stroke or TIA admitted within 12 h of symptom onset. Patients with moderate-severe stenosis of the middle cerebral artery or basilar artery (BA) were included. All patients underwent MRI, including diffusion-weighted imaging (DWI), and magnetic resonance angiography. DWI lesion patterns were classified as perforating artery infarcts, pial infarcts, territorial infarcts and border zone infarcts (BIs). END was diagnosed as an increase of > or =4 points on the National Institutes of Health Stroke Scale from baseline during the 1st week.
RESULTS: Of the 95 patients enrolled in the study, 14 (14.7%) developed END. Independent predictors of END were the presence of BIs on baseline DWI (odds ratio, OR, 7.21; 95% confidential interval, CI, 1.88-27.66; p = 0.004) and BA disease (OR, 4.33; 95% CI, 1.11-16.92; p = 0.035).
CONCLUSIONS: ICAS patients with BI and BA disease are at high risk of END after minor stroke or TIA. Early radiological findings may be helpful in predicting END and guiding early treatment strategies.
Authors:
Joon-Tae Kim; Hye-Jin Kim; Sung-Hee Yoo; Man-Seok Park; Sun U Kwon; Ki-Hyun Cho; Jong S Kim; Dong-Wha Kang
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-09
Journal Detail:
Title:  European neurology     Volume:  64     ISSN:  1421-9913     ISO Abbreviation:  Eur. Neurol.     Publication Date:  2010  
Date Detail:
Created Date:  2010-08-09     Completed Date:  2010-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0150760     Medline TA:  Eur Neurol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  95-100     Citation Subset:  IM    
Copyright Information:
Copyright 2010 S. Karger AG, Basel.
Affiliation:
Department of Neurology, Chonnam National University Hospital, Gwangju, Republic of Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Diffusion Magnetic Resonance Imaging
Disease Progression
Follow-Up Studies
Humans
Intracranial Arteriosclerosis / complications
Ischemic Attack, Transient / complications*,  etiology,  radionuclide imaging
Magnetic Resonance Angiography
Magnetic Resonance Imaging / methods*
Middle Aged
Nervous System Diseases / diagnosis*,  etiology,  radionuclide imaging
Retrospective Studies
Severity of Illness Index
Statistics, Nonparametric
Stroke / complications*,  etiology,  radionuclide imaging

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