Factors Associated With Focal Computed Tomographic Perfusion Abnormalities in Supratentorial Transient Ischemic Attacks.

Details

Serval ID
serval:BIB_97A13A40241A
Type
Article: article from journal or magazin.
Collection
Publications
Title
Factors Associated With Focal Computed Tomographic Perfusion Abnormalities in Supratentorial Transient Ischemic Attacks.
Journal
Stroke
Author(s)
Meyer I.A., Cereda C.W., Correia P.N., Zerlauth J.B., Puccinelli F., Rotzinger D.C., Amiguet M., Maeder P., Meuli R.A., Michel P.
ISSN
1524-4628 (Electronic)
ISSN-L
0039-2499
Publication state
Published
Issued date
01/2018
Peer-reviewed
Oui
Volume
49
Number
1
Pages
68-75
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Computed tomographic perfusion (CTP) is useful in diagnosis of patients with transient focal neurological symptoms. In acute imaging of patients with a suspected transient ischemic attack (TIA), it remains unclear which patients develop focal perfusion abnormalities (FPA), that is, hypoperfusion or hyperperfusion. We aimed at determining independent factors associated with FPA in patients with supratentorial TIAs.
We prospectively collected consecutive patients with supratentorial TIAs defined by the traditional time-based definition who underwent CTP within 24 hours of symptom onset. We recorded demographics, risk factors, clinical features, severity, and timing from onset. We documented the Age, Blood Pressure, Clinical Features, Duration, and Diabetes (ABCD2) scores, vascular territories, and presence of relevant arterial pathology. Variables were tested for an association with FPA with univariate and multivariate analyses.
A hundred and ten of 265 patients (42%) with supratentorial TIAs had FPA on CTP. Acute noncontrast computed tomography showed early ischemic lesions in 6%, and acute/subacute magnetic resonance imaging was pathological in 52 of the 109 cases (47.7%) where it was performed. Clinical factors associated with FPA were high-admission National Institutes of Health Stroke Scale (odds ratio [OR], 1.22), right hemispheric TIA (OR, 3.09), and cardioembolic mechanism (OR, 2.19). Persistence of symptoms during CTP (OR, 2.59), shorter duration of TIA (OR, 0.93), major intracranial arterial pathology (OR, 12.5), and extracranial arterial occlusion (OR, 7.44) were also associated with FPA.
Supratentorial TIAs are often associated with FPA in CTP, even after symptom resolution. FPAs are frequent in severe TIAs and those associated with cardioembolism or specific arterial pathologies. These findings can help clinicians in accurate diagnosis of TIA and its underlying mechanisms.

Keywords
Aged, Aged, 80 and over, Brain Ischemia/diagnostic imaging, Brain Ischemia/physiopathology, Cerebrovascular Circulation, Female, Humans, Male, Middle Aged, Perfusion Imaging, Prospective Studies, Retrospective Studies, Tomography, X-Ray Computed, computed tomography angiography, ischemic attack, multivariate analysis, perfusion, risk factors
Pubmed
Web of science
Open Access
Yes
Create date
29/12/2017 13:14
Last modification date
20/08/2019 14:59
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