Neurological Evaluation and Diffusion-Weighted MRI Assessment of Patients with Transient Ischemic Attacks

Background: The risk of stroke after a transient ischemic attack (TIA) is high. Appropriately directed therapies may reduce this risk. However, sensitive means of detecting the presence of transient neuronal ischemia are lacking. Objective: To analyze the incidence of ischemic lesions detected by using diffusion-weighted MR imaging in patients suffering from transient ischemic attacks (TIA), and to determine whether the presence of a diffusion image abnormality and their neuro-anatomical location correlates with the clinical presentation and duration of symptoms. Methods: Thirty six patients presented with TIA underwent diffusion-weighted MR imaging within 24 hours of symptoms. Results: Twenty six patients (72.3%) had normal DW images while 10 patients (27.7%) showed positive lesions. It was found that, although there was slightly longer median symptom duration in patients with positive DWI compared to negative cases, it was of no statistically significant difference. The anatomical location of the positive cases was matching with their clinical neurological presentation. Conclusion: Accordingly, we can consider that patients with TIAs are at high risk of early stroke, and their risk can be evaluated by clinical scale, and diffusion magnetic resonance imaging. [Egypt J Neurol Psychiat Neurosurg. 2010; 47(3): 447-452]