Article Figures & Data
Figures
- Fig 1.
A 57-year-old woman with right transient hemiparesis (clinical duration = 2 minutes, delay since the first clinical symptom = 12 hours). ABCD2 score = 4. A, DWI shows some foci of high signal intensity in the left frontal lobe with a decrease of ADC on the ADC map (B). C, 3D TOF reveals a significant proximal stenosis of the left M1 segment (arrow). The patient had another right transient impairment in the subsequent 48 hours.
- Fig 2.
A 59-year-old man with left regressive hemiparesis (clinical duration = 3 minutes, delay since the first clinical symptom = 3 hours). ABCD2 score = 4. A, DWI demonstrates a subtle hyperintensity in the right subinsular region with corresponding decrease of ADC on the ADC map (B). C, 3D TOF depicts right M1 segment grade 2 occlusion (arrow), responsible for the acute ischemic lesion in the insular lobe. The patient had another left transient hemiparesis in the subsequent 48 hours.
Tables
Intracranial Artery Stenosis/Occlusion (n = 16) No Intracranial Artery Stenosis/Occlusion (n = 113) P Value Age (yr) (mean) (SD) 67.9 (8.9) 62.9 (15.9) .22 Male 8 (50.0) 66 (58.4) .59 Hypertension 9 (56.3) 48 (42.5) .42 Cigarette smoking 3 (18.8) 29 (27.5) 1 Hypercholesterolemia 6 (37.5) 42 (37.2) .97 Previous stroke/TIA 2 (12.5) 15 (13.3) 1 Diabetes 4 (25.0) 10 (8.8) .07 ABCD2 score ≥4 11 (68.8) 56 (49.6) .18 Extracranial carotid stenosis >50% 2 (12.5) 10 (8.3) .64 Atrial fibrillation 1 (6.3) 8 (7.1) 1 Acute infarction on DWI 13 (81.2) 29 (25.6) <.001 ↵a Values in parentheses are percentages unless otherwise indicated.
Patient No. Type of Recurrence ABCD2 Score Acute Infarction on DWI MRA Lesion 1 Stroke 4 No None 2 TIA 4 Yes Proximal occlusion 3 TIA 3 No Proximal stenosis 4 TIA 4 No None 5 TIA 5 Yes None 6 Stroke 6 No None 7 TIA 5 No None 8 TIA 5 No None 9 TIA 4 Yes Proximal stenosis - Table 3:
Performance of MRI variables as predictors of recurrent transient ischemic attack or stroke at 7 days among 129 patients evaluated within 24 hours of symptom onset
Sensitivity (%) (No.) Specificity (%) (No.) Positive Predictive Value (%) (No.) Negative Predictive Value (%) (No.) Odds Ratio (95% Confidence Interval) P Value DWI 33.3 (3/9) 67.5 (81/120) 7.1 (3/42) 93.1 (81/87) 1.03 (0.24–4.37) 1 MRA 33.3 (3/9) 89.2 (107/120) 18.8 (3/16) 94.7 (107/113) 4.11 (0.91–18.4) .08 MRA proximal 33.3 (3/9) 93.3 (112/120) 27.3 (3/11) 94.9 (112/118) 7.0 (1.47–33.3) .03 Note:—DWI indicates acute infarction on DWI; MRA, distal or proximal stenosis or occlusion of symptomatic intracranial artery on MR angiography; MRA proximal, proximal stenosis or occlusion of symptomatic intracranial artery on MR angiography.
Early Recurrence (n = 9) No Early Recurrence (n = 120) P Valueb Atrial fibrillation 1 (11.1) 8 (6.7) 1 Extracranial carotid stenosis >50% 1 (11.1) 11 (9.2) 1 ABCD2 score ≥4 8 (88.9) 59 (49.2) 0.03
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