CT identifies TIA patients at high risk for Stroke

Wasserman et al in a study published by the journal Stroke report that computed tomography (CT) findings can predict subsequent stroke on patients with transient ischemic attacks (TIA).

Their multicenter prospective cohort study enrolled a total of 2028 patients; 814 of who had ischemic changes on CT and were patients with a clinical diagnosis of an transient ischemic attack or non-disabling stroke and had CT scanning within 24 hours of the event. Primary outcome was subsequent stroke within 90 days. Secondary outcomes were stroke at ≤2 or >2 days. CT findings were classified as acute or chronic ischemia present or absent and or microangiopathy.

The stroke rate was 3.4% at 90 days and 1.5% at ≤2 days. Stroke risk was greater if baseline CT showed acute ischemia alone (10.6%; P=0.002), it was higher in patients with CT findings of acute and chronic ischemia (17.4%; P=0.007), and in those with acute ischemia and microangiopathy (17.6%; P=0.019), and the highest when CT findings of all three acute, chronic ischemia and microangiopathy were present (25.0%; P=0.029).

They concluded that patients with transient ischemic attack/non-disabling stroke, subtle CT findings of acute ischemia alone or acute ischemia with chronic ischemia or microangiopathy were associated with increased subsequent stroke risk between 10-25% within 90 days.