FLAIR vascular hyperintensities predict early ischemic recurrence in TIA

Ki Woong Nam, Chi Kyung Kim, Tae Jung Kim, Kyungmi Oh, Moon Ku Han, Sang Bae Ko, Byung Woo Yoon

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5 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate the relationship between fluid-attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH) and early ischemic lesion recurrence (follow-up diffusion-weighted imaging [FU-DWI] [+]) in patients with lesion-negative TIA. METHODS: We recruited consecutive patients with lesion-negative TIA within 24 hours of symptom onset, who underwent follow-up MRI during the acute period. FVH was defined as a focal or serpentine high signal intensity on FLAIR images. Other potential confounders were adjusted to evaluate the relationship between FVH and FU-DWI (+). Furthermore, to compare clinical outcomes between the FU-DWI (+) and FU-DWI (-) groups, we assessed 1-year recurrent ischemic stroke or TIA. RESULTS: Among 392 patients with lesion-negative TIA, 82 patients had FU-DWI (+) on the follow-up MRI. In the multivariate analysis, FVH remained an independent predictor of FU-DWI (+) (adjusted odds ratio [aOR] = 4.77, 95% confidence interval [CI] 2.45-9.29, p < 0.001). The time to initial MRI (aOR = 0.49, 95% CI = 0.33-0.70, p < 0.001) and intracranial atherosclerosis (aOR = 2.07, 95% CI = 1.10-3.92, p = 0.025) were also associated with FU-DWI (+), independent of FVH. In clinical outcomes, the FU-DWI (+) group showed more frequent 1-year recurrent ischemic stroke events than the FU-DWI (-) group (10.7% vs 3.1%, respectively, p = 0.007). CONCLUSIONS: FVH is associated with FU-DWI (+) in patients with lesion-negative TIA. As FU-DWI (+) frequently occurs during the acute period and has a subsequent worse outcome after discharge, additional radiologic or clinical markers for it are necessary.

Original languageEnglish
Pages (from-to)e738-e744
JournalNeurology
Volume90
Issue number9
DOIs
Publication statusPublished - 2018 Feb 27

ASJC Scopus subject areas

  • Clinical Neurology

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    Nam, K. W., Kim, C. K., Kim, T. J., Oh, K., Han, M. K., Ko, S. B., & Yoon, B. W. (2018). FLAIR vascular hyperintensities predict early ischemic recurrence in TIA. Neurology, 90(9), e738-e744. https://doi.org/10.1212/WNL.0000000000005034