TY - JOUR T1 - Intracranial Artery Stenosis or Occlusion Predicts Ischemic Recurrence after Transient Ischemic Attack JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 185 LP - 190 DO - 10.3174/ajnr.A3144 VL - 34 IS - 1 AU - G. Ssi-Yan-Kai AU - N. Nasr AU - A. Faury AU - I. Catalaa AU - C. Cognard AU - V. Larrue AU - F. Bonneville Y1 - 2013/01/01 UR - http://www.ajnr.org/content/34/1/185.abstract N2 - 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 >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 ER -