Abstract:
:Background and Purpose- The diagnosis of transient ischemic attack is challenging. Evidence of acute ischemia on MRI diffusion-weighted imaging is highly variable and confirmed in only about one-third of patients. This study investigated the significance of blood-brain barrier dysfunction (BBBD) mapping in patients with transient neurological deficits, as a diagnostic and prognostic biomarker required for risk stratification and stroke prevention. Methods- We used dynamic contrast-enhanced MRI to quantitatively map BBBD in a prospective cohort study of 57 patients diagnosed with transient ischemic attack/minor stroke and 50 healthy controls. Results- Brain volume with BBBD was significantly higher in patients compared with controls ( P=0.002). BBBD localization corresponded with the clinical presentation in 41 patients (72%) and was more extensive in patients with acute infarct on diffusion-weighted imaging ( P=0.05). Patients who developed new stroke during follow-up had a significantly greater BBBD at the initial presentation ( P=0.03) with a risk ratio of 5.35 for recurrent stroke. Conclusions- This is the first description of the extent and localization of BBBD in patients with transient ischemic attack/minor stroke. We propose BBBD mapping as a valuable tool for detection of subtle brain ischemia and a promising predictive biomarker required for risk stratification and stroke prevention.
journal_name
Strokejournal_title
Strokeauthors
Serlin Y,Ofer J,Ben-Arie G,Veksler R,Ifergane G,Shelef I,Minuk J,Horev A,Friedman Adoi
10.1161/STROKEAHA.119.025247subject
Has Abstractpub_date
2019-05-01 00:00:00pages
1266-1269issue
5eissn
0039-2499issn
1524-4628journal_volume
50pub_type
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