Brain CT Can Predict Subsequent Stroke Following TIA

December 8, 2014

CT images help identify patients who may have a subsequent stroke within three months of experiencing a TIA.

Computed tomography images of the brain of patients who experienced a transient ischemic attack (TIA) or non-disabling stroke, may predict subsequent stroke risk within 90 days, according to a new study published in the journal Stroke.

Researchers from Canada performed a prospective cohort study to assess the association of CT findings of acute ischemia, chronic ischemia, or microangiopathy for predicting stroke following a TIA or non-disabling strokes. The primary outcome was subsequent stroke within 90 days, secondary outcomes were stroke at two or fewer days, or more than two days following the initial TIA or stroke.

"All patients should get a CT scan of their brain after a TIA or non-disabling stroke," co-senior author Jeffrey J. Perry, MD, MSc, associate professor of emergency medicine, University of Ottawa in Canada, said in a release. "Images can help healthcare professionals identify patterns of damage associated with different levels of risk for a subsequent stroke or help predict when symptoms may get worse.”

A total of 2,028 patients who had experienced a TIA or non-disabling stroke were included in the study. All had undergone a CT scan with 24 hours of the TIA or stroke. The CT images showed that 814 of the patients (40.1%) had ischemic changes. The subsequent stroke rate was 3.4% at 90 days and 1.5% at two or fewer days.[[{"type":"media","view_mode":"media_crop","fid":"30075","attributes":{"alt":"co-senior author Jeffrey J. Perry, MD, MSc","class":"media-image media-image-right","id":"media_crop_6841617330111","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"3141","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 150px; width: 150px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"co-senior author Jeffrey J. Perry, MD, MSc","typeof":"foaf:Image"}}]]

The researchers found that stroke risk was greater if the baseline CT showed acute ischemia alone (10.6% of patients with changes), acute and chronic ischemia (17.4%), or acute ischemia and microangiopathy (17%). Twenty-five percent of patients had acute, chronic ischemia and microangiopathy.

"These findings should prompt physicians to be more aggressive in managing patients with TIA or non-disabling stroke who are diagnosed with acute ischemia, especially if there is additional chronic ischemia and/or microangiopathy," Perry noted in the release.