BACKGROUND: Little is known about short-term vascular risk after transient ischemic attack (TIA) caused by intracranial atherosclerosis. OBJECTIVES: To quantify the early risk of ischemic stroke in the territory of a stenotic intracranial artery after TIA and to identify clinical and imaging features associated with increased risk of stroke in the territory among patients with TIA. DESIGN: Cohort study. SETTING: Academic research. Patients The Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) study enrolled patients having TIA or nondisabling stroke within the preceding 3 months and demonstrating corresponding 50% to 99% stenosis of a major intracranial artery on angiography. MAIN OUTCOME MEASURES: We calculated the cumulative risk of stroke in the territory of the symptomatic artery during the first 90 days after randomization among patients having TIA alone as a qualifying event compared with patients having stroke alone. We assessed selected factors for association with stroke among patients having TIA as the qualifying event. RESULTS: The 90-day risk of ischemic stroke in the arterial territory was 6.9% (95% confidence interval, 4.2%-11.2%) after TIA compared with 4.7% (95% confidence interval, 2.7%-8.4%) after stroke (P =.32). Among patients having TIA alone as the qualifying event, 60.0% (15 of 25) of all strokes in the arterial territory occurred in the first 90 days compared with 34.4% (11 of 32) among patients having stroke alone as the qualifying event (P =.05). Among subjects with TIA, the presence of cerebral infarct on baseline neuroimaging was the only statistically significant predictor of higher risk of early stroke (hazard ratio, 4.7; 95% confidence interval, 1.4-15.5; P =.006). CONCLUSIONS: Among individuals having intracranial atherosclerotic disease with TIA, most subsequent strokes in the territory of a stenotic intracranial artery occur early (ie, < or =90 days). Prompt management of TIA in patients having intracranial stenosis, particularly those demonstrating cerebral infarction on brain imaging, is indicated.
RCT Entities:
BACKGROUND: Little is known about short-term vascular risk after transient ischemic attack (TIA) caused by intracranial atherosclerosis. OBJECTIVES: To quantify the early risk of ischemic stroke in the territory of a stenotic intracranial artery after TIA and to identify clinical and imaging features associated with increased risk of stroke in the territory among patients with TIA. DESIGN: Cohort study. SETTING: Academic research. Patients The Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) study enrolled patients having TIA or nondisabling stroke within the preceding 3 months and demonstrating corresponding 50% to 99% stenosis of a major intracranial artery on angiography. MAIN OUTCOME MEASURES: We calculated the cumulative risk of stroke in the territory of the symptomatic artery during the first 90 days after randomization among patients having TIA alone as a qualifying event compared with patients having stroke alone. We assessed selected factors for association with stroke among patients having TIA as the qualifying event. RESULTS: The 90-day risk of ischemic stroke in the arterial territory was 6.9% (95% confidence interval, 4.2%-11.2%) after TIA compared with 4.7% (95% confidence interval, 2.7%-8.4%) after stroke (P =.32). Among patients having TIA alone as the qualifying event, 60.0% (15 of 25) of all strokes in the arterial territory occurred in the first 90 days compared with 34.4% (11 of 32) among patients having stroke alone as the qualifying event (P =.05). Among subjects with TIA, the presence of cerebral infarct on baseline neuroimaging was the only statistically significant predictor of higher risk of early stroke (hazard ratio, 4.7; 95% confidence interval, 1.4-15.5; P =.006). CONCLUSIONS: Among individuals having intracranial atherosclerotic disease with TIA, most subsequent strokes in the territory of a stenotic intracranial artery occur early (ie, < or =90 days). Prompt management of TIA in patients having intracranial stenosis, particularly those demonstrating cerebral infarction on brain imaging, is indicated.
Authors: Petrice M Cogswell; Taylor L Davis; Megan K Strother; Carlos C Faraco; Allison O Scott; Lori C Jordan; Matthew R Fusco; Blaise deB Frederick; Jeroen Hendrikse; Manus J Donahue Journal: J Magn Reson Imaging Date: 2017-01-06 Impact factor: 4.813
Authors: Manus J Donahue; Eric Achten; Petrice M Cogswell; Frank-Erik De Leeuw; Colin P Derdeyn; Rick M Dijkhuizen; Audrey P Fan; Rashid Ghaznawi; Jeremy J Heit; M Arfan Ikram; Peter Jezzard; Lori C Jordan; Eric Jouvent; Linda Knutsson; Richard Leigh; David S Liebeskind; Weili Lin; Thomas W Okell; Adnan I Qureshi; Charlotte J Stagg; Matthias Jp van Osch; Peter Cm van Zijl; Jennifer M Watchmaker; Max Wintermark; Ona Wu; Greg Zaharchuk; Jinyuan Zhou; Jeroen Hendrikse Journal: J Cereb Blood Flow Metab Date: 2017-08-17 Impact factor: 6.200
Authors: David S Liebeskind; George A Cotsonis; Jeffrey L Saver; Michael J Lynn; Tanya N Turan; Harry J Cloft; Marc I Chimowitz Journal: Ann Neurol Date: 2011-03-17 Impact factor: 10.422
Authors: Marios Psychogios; Alex Brehm; Elena López-Cancio; Gian Marco De Marchis; Elena Meseguer; Aristeidis H Katsanos; Christine Kremer; Peter Sporns; Marialuisa Zedde; Adam Kobayashi; Jildaz Caroff; Daniel Bos; Sabrina Lémeret; Avtar Lal; Juan F Arenillas Journal: Eur Stroke J Date: 2022-06-03