Imaging Predictors of Outcome in Patients with Transient Ischemic Attacks and Minor Stroke: Review of published data from the VISION study

REVIEW, August 2011, VOL I ISSUE IV, ISSN 2042-4884
10.5083/ejcm.20424884.50 , Cite or Link Using DOI
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Negar Asdaghi, Shelagh B. Coutts

ABSTRACT

Urgent neuroimaging has become an integral part of the care of patients with ischemic stroke. In patients with transient ischemic attack (TIA) and minor stroke (MIS) this information is used along with patient’s clinical characteristics to triage patients into high and low risk categories. It is well recognised that patients with TIA/MIS are at high risk of having a recurrent ischemic event and this risk is highest in the first 48 hours after the index event. Early identification of those at high risk of recurrence is therefore important for triaging and implementing treatment strategies including the need for hospital admission, urgent investigations and aggressive treatments. In this review we discuss the role of modern vascular and parenchymal neuroimaging in predicting clinical and radiographic outcomes in patients with ischemic stroke, focusing mainly on the subgroup of patients with transient or minor neurological symptoms at presentation.

INTRODUCTION

Transient ischemic attack (TIA) and minor stroke (MIS) represent disorders on the same ischemic continuum. It is now well established that these patients are at high risk for early deterioration and recurrent ischemic events. Although clinical characteristics are important for identifying high-risk patients, the sensitivity of clinical scoring systems in correctly predicting a recurrent event is far from perfect. Multiple studies over the past decade have evaluated the ability of modern neuroimaging in isolation or in combination with the clinical features in triaging these patients.