This Article Full Text Full Text (PDF) All Versions of this Article: 34/12/2898    most recent 01.STR.0000106670.19525.D9v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Silver, B. Search for Related Content PubMed PubMed Citation Articles by Silver, B. Pubmed/NCBI databases Medline Plus Health Information Stroke Transient Ischemic Attack

(Stroke. 2003;34:2898.)
© 2003 American Heart Association, Inc.

Original Contributions

Editorial Comment—Neuroimaging After TIA: A Crystal Ball?

Department of Neurology, Henry Ford Hospital, Detroit, Mich

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Previous studies of the Kaiser-Permanente Northern California database have indicated that 10.5% of patients will develop stroke in the 90 days after a TIA and that approximately half of these events will occur within 48 hours.¹ In this issue of Stroke, Douglas et al query the same database to provide novel information regarding the short-term risk associated with a new infarction on head CT after symptoms of TIA.² In their study, 4% of 322 patients had this finding, which was associated with an approximately 4-fold increase in the risk of stroke in the next 90 days, after adjusting for all other known risk factors. In absolute terms, 38% (5 of 13) of patients in the group with new infarction on initial head CT had a new stroke in the following 90 days compared with nearly 10% (30 of 309) of patients who had no such findings on initial imaging. Other imaging variables studied (including old infarction, periventricular white matter disease, atrophy, and vascular calcification) had no statistical relationship with follow-up events. An additional finding in this study, comparable to previous studies, was that 1% of patients had a nonischemic etiology as a presumed cause of symptoms.

What implications will these findings have on clinical practice? Considering that the current AHA guidelines already recommend imaging for patients after TIA,^3,4 there will likely be no significant change among neurologists who see these patients primarily. However, many patients with TIA are not seen by neurologists and frequently do not undergo neuroimaging as . . . [Full Text of this Article]