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Göteborgs universitets publikationer

Frequency and predictors of acute ischaemic lesions on brain magnetic resonance imaging in young patients with a clinical diagnosis of transient ischaemic attack

Författare och institution:
C. Tanislav (-); U. Grittner (-); F. Fazekas (-); V. Thijs (-); Turgut Tatlisumak (Institutionen för neurovetenskap och fysiologi); R. Huber (-); B. von Sarnowski (-); J. Putaala (-); R. Schmidt (-); P. Kropp (-); B. Norrving (-); P. Martus (-); C. Gramsch (-); A. K. Giese (-); A. Rolfs (-); C. Enzinger (-)
Publicerad i:
European Journal of Neurology, 23 ( 7 ) s. 1174-1182
ISSN:
1351-5101
Publikationstyp:
Artikel, refereegranskad vetenskaplig
Publiceringsår:
2016
Språk:
engelska
Fulltextlänk:
Sammanfattning (abstract):
Background and purposeAcute lesions in patients with transient ischaemic attack (TIA) are important as they are associated with increased risk for recurrence. Characteristics associated with acute lesions in young TIA patients were therefore investigated. MethodsThe sifap1 study prospectively recruited a multinational European cohort (n = 5023) of patients aged 18-55 years with acute cerebrovascular event. The detection of acute ischaemic lesions was based on diffusion-weighted imaging (DWI). The frequency of DWI lesions was assessed in 829 TIA patients who met the criteria of symptom duration <24 h and their association with demographic, clinical and imaging variables was analysed. ResultsThe median age was 46 years (interquartile range 40-51 years); 45% of the patients were female. In 121 patients (15%) 1 acute DWI lesion was detected. In 92 patients, DWI lesions were found in the anterior circulation, mostly located in cortical-subcortical areas (n = 63). Factors associated with DWI lesions in multiple regression analysis were left hemispheric presenting symptoms [odds ratio (OR) 1.92, 95% confidence interval (CI) 1.27-2.91], dysarthria (OR 2.17, 95% CI 1.38-3.43) and old brain infarctions on MRI (territories of the middle and posterior cerebral artery: OR 2.43, 95% CI 1.42-4.15; OR 2.41, 95% CI 1.02-5.69, respectively). ConclusionsIn young patients with a clinical TIA 15% demonstrated acute DWI lesions on brain MRI, with an event pattern highly suggestive of an embolic origin. Except for the association with previous infarctions there was no clear clinical predictor for acute ischaemic lesions, which indicates the need to obtain MRI in young individuals with TIA.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
MEDICIN OCH HÄLSOVETENSKAP ->
Klinisk medicin ->
Neurologi
Nyckelord:
acute cerebral infarction, magnetic resonance imaging, transient ischaemic attack, young stroke, diffusion-weighted mri, early stroke risk, fabry patients, multicenter, guidelines, management, disease, sifap1, care, tia
Postens nummer:
239457
Posten skapad:
2016-07-25 13:41

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