Perfusion computed tomography in transient ischemic attack

Shyam Prabhakaran*, Sohal K. Patel, Jordan Samuels, Bethany McClenathan, Yousef Mohammad, Vivien H. Lee

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Background: Diffusion- and perfusion-weighted imaging after transient ischemic attack (TIA) has been well studied, while less data exist on perfusion computed tomographic (PCT) imaging. Objectives: To examine the frequency of PCT abnormalities in patients with anterior circulation TIA and to identify factors associated with the presence of PCT abnormality. Design: Retrospective study. Setting: Academic hospital. Patients: Sixty-five consecutive patients admitted to Rush University Medical Center, Chicago, Illinois, between June 1, 2007, and November 30, 2009, for anterior circulation motor or aphasic TIA in whom PCT was performed. Main Outcome Measures: Using an automated software algorithm, perfusion abnormality was defined as brain tissue associated with amean transit time greater than 145% of that of the contralateral hemisphere and cerebral blood volume greater than 2.0 mL/100 g. Demographic, risk factor, clinical, radiographic, and in-hospital outcome data were reviewed. Results: Of 65 patients with anterior circulation TIA who underwent PCT (median age, 62.4 years; 49.2% male), 22 (33.8%) had focal perfusion abnormalities. The presence of motor symptoms (95.5% vs 67.4%, P=.01), multiple (>1) episodes (18.2% vs 2.3%, P=.04), ipsilateral arterial stenosis greater than50%or occlusion (77.3% vs 11.6%, P<.001), large-artery atherosclerosis subtype (59.1% vs 9.3%, P<.001), and subsequent in-hospital events (22.7% vs 0%, P=.001) were more frequent in those with perfusion abnormality. Conclusions: On acutely performed PCT, one-third of patients with hemispheric TIA have perfusion abnormalities. Perfusion abnormality may mark patients at greater risk for subsequent early deterioration. This requires further study.

Original languageEnglish (US)
Pages (from-to)85-89
Number of pages5
JournalArchives of Neurology
Volume68
Issue number1
DOIs
StatePublished - Jan 2011

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

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