What are the MRI findings characteristic of TIA?

Updated: Dec 19, 2018
  • Author: Souvik Sen, MD, MPH, MS, FAHA; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

A third to a half of the patients presenting with a TIA have lesions on DWI. A significant proportion of these patients may not reveal a corresponding lesion on T2-WI. PWI may be more sensitive but has not been adequately tested in patients with TIA.

Although TIAs have been traditionally defined as transient (< 24 h) neurologic deficits of vascular origin, the advent of MRI has led to reconsideration of the definition. Recent tissue definitions of stroke emphasize that TIA with persistent ischemia on diffusion-weighted imaging is classified as stroke rather than a TIA. TIA, on the other hand, requires either a normal diffusion-weighted image without evidence of ischemia or reversible changes on DWI suggestive of ischemia rather than infarction. [13]

Recently, brain imaging (DWI) has been added to the clinical ABCD2 to identify patients with TIA with a high risk of stroke recurrence. The ABCD3-I score uses DWI and intracranial atherosclerosis detected by MRA to add prognostic value to the traditional ABCD2 score. It appears that DWI abnormality increases the ability to predict stroke at 7 and 90 days in patients presenting with clinical TIA. Intracranial disease on MRA seems to add to this score in a nonsignificant way. [14]

Go to Transient Ischemic Attack for more complete information on this topic.


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