scholarly journals Impact of Glycemic Control on Efficacy of Clopidogrel in Transient Ischemic Attack or Minor Stroke Patients With CYP2C19 Genetic Variants

Stroke ◽  
2017 ◽  
Vol 48 (4) ◽  
pp. 998-1004 ◽  
Author(s):  
Yi Lin ◽  
Anxin Wang ◽  
Jiejie Li ◽  
Jinxi Lin ◽  
David Wang ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Transient Ischemic Attack ◽  
Genetic Variants ◽  
Minor Stroke ◽  
Stroke Patients ◽  
Ischemic Attack

Abstract 41: Prognostic Value of Perfusion MRI in Patients with Transient Ischemic Attack or Minor Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Joon Hwa Lee ◽  
Hyunjin Jo ◽  
Jihoon Cha ◽  
Woo-Keun Seo ◽  
Oh Young Bang ◽  
...  
Keyword(s):  
Cardiovascular Event ◽  
Transient Ischemic Attack ◽  
Recurrent Stroke ◽  
Perfusion Mri ◽  
Minor Stroke ◽  
Secondary Outcome ◽  
Stroke Recurrence ◽  
Composite Outcome ◽  
Stroke Patients ◽  
Ischemic Attack

Background and purpose: We aimed to investigate the role of perfusion MRI parameters (TTP: time to peak, CBF: cerebral blood flow, CBV: cerebral blood volume) as a prognostic factor for the risk of stroke recurrence or cardiovascular outcome in patients with transient ischemic attack (TIA) or minor stroke. Methods: We retrospectively reviewed TIA or minor stroke patients who underwent our stroke MRI protocol (DWI, perfusion MRI, and MRA) in a consecutively collected stroke registry. Primary outcome was nonfatal stroke recurrence and secondary outcome was cardiovascular composite outcome. Multivariate analysis was used to examine the association of perfusion MRI parameters and angiographic findings with the risk of stroke recurrence and cardiovascular event. Results: Of the 326 patients who met inclusion criteria, we identified 15(4.6%) nonfatal strokes and 25(7.7%) cardiovascular composite events during the first 1 year after the index TIA or minor stroke. The presence of regional delayed perfusion on TTP maps (p=0.002) and regional hyperperfusion on CBV maps (p<0.001) were associated with recurrent stroke. In MRA images, concomitant stenosis of the intracranial arteries and/or extracranial carotid arteries was associated with cardiovascular events (p=0.009). Using multivariate cox proportional hazard analysis, presence of regional hyperperfusion on CBV remained an independent predictor of recurrent stroke (HR 10.82, 95% CI 4.19-38.67, p<0.001) and cardiovascular event (HR 6.30, 95% CI 2.67-18.25, p<0.001). The AUC of the CBV maps was also greater than other parameters for the prediction of stroke recurrence (AUC=0.701, 95% CI 0.54-0.86) and cardiovascular composite outcome (AUC=0.628, 95% CI 0.50-0.76). Conclusions: Increased CBV on perfusion MRI, representing the hemodynamic status of postischemic hyperperfusion, could be more useful than other perfusion parameters in predicting poor prognosis of TIA or minor stroke patients.

Triaging transient ischemic attack and minor stroke patients using acute magnetic resonance imaging

2005 ◽  
Vol 57 (6) ◽  
pp. 848-854 ◽  
Author(s):  
Shelagh B. Coutts ◽  
Jessica E. Simon ◽  
Michael Eliasziw ◽  
Chul-Ho Sohn ◽  
Michael D. Hill ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Transient Ischemic Attack ◽  
Minor Stroke ◽  
Resonance Imaging ◽  
Stroke Patients ◽  
Ischemic Attack

scholarly journals Patients Referred for TIA May Still Have Persisting Neurological Deficits

2012 ◽  
Vol 39 (2) ◽  
pp. 170-173 ◽  
Author(s):  
Francois Moreau ◽  
Thomas Jeerakathil ◽  
Shelagh B. Coutts ◽  
Keyword(s):  
Emergency Room ◽  
Neurological Examination ◽  
Transient Ischemic Attack ◽  
Neurological Deficit ◽  
Neurological Deficits ◽  
Minor Stroke ◽  
Stroke Patients ◽  
Southern Alberta ◽  
Physician Family ◽  
Ischemic Attack

Background:The presence of residual neurological deficits after neurological symptoms is important information for making a diagnosis of Transient Ischemic Attack (TIA) versus stroke. The purpose of this study was to establish the reliability of the referring physician (non neurologist) to report focal neurological deficits in the context of an urgent referral for TIA.Methods:Prospectively recorded urgent physician-to-physician phone referrals for TIA through the Southern Alberta TIA hotline from March 2009 to July 2010 were reviewed. “Has the neurological deficit completely resolved?” was asked to the referring physician (family or emergency room physician) and recorded prospectively as a yes/no response. Patients were included if a neurological examination was performed by a neurologist on the same day as referral. The neurologist's assessment of whether the deficit had resolved was compared to that of the referring physician.Results:78 patients were included in this study. 62 patients had resolved as per the referring physician's assessment. Of these 62 patients, 16 (25.8% 95%CI 16-38) had evidence of persisting neurological deficits on the neurologist's assessment. A wide variety of mild neurological deficits were identified. None of these deficits appeared to be explained by progression of symptoms.Conclusion:Physicians referring patients with TIA syndromes for emergent assessment do not reliably detect mild residual deficits in one-quarter of patients. We are questioning the validity of neurological deficit resolution as a triage rule. The findings suggest that studies of TIA likely include a proportion of minor stroke patients and this should be remembered when extrapolating the results to other populations.

scholarly journals High Rate of Magnetic Resonance Imaging Stroke Recurrence in Cryptogenic Transient Ischemic Attack and Minor Stroke Patients

Stroke ◽  
2012 ◽  
Vol 43 (12) ◽  
pp. 3387-3388 ◽  
Author(s):  
Simerpreet Bal ◽  
Shiel K. Patel ◽  
Mohammed Almekhlafi ◽  
Jayesh Modi ◽  
Andrew M. Demchuk ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Transient Ischemic Attack ◽  
High Rate ◽  
Minor Stroke ◽  
Stroke Recurrence ◽  
Resonance Imaging ◽  
Stroke Patients ◽  
Ischemic Attack

scholarly journals Does Abnormal Circadian Blood Pressure Pattern Really Matter in Patients With Transient Ischemic Attack or Minor Stroke?

Stroke ◽  
2014 ◽  
Vol 45 (3) ◽  
pp. 865-867 ◽  
Author(s):  
WenWen Zhang ◽  
Dominique A. Cadilhac ◽  
Leonid Churilov ◽  
Geoffrey A. Donnan ◽  
Christopher O’Callaghan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Transient Ischemic Attack ◽  
Minor Stroke ◽  
Pressure Pattern ◽  
Circadian Blood Pressure ◽  
Ischemic Attack
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