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.
