MR Angiography in Patients with Transient Ischemic Attack

Lee, Se Jin

Abstract

BACKGROUND: Several western studies have found an occurrence of abnormal angiographic findings in 60-80% of patients with carotid artery territory transient ischemic attack(below carotid TIA) and showed that the location of pathology was frequent in extracranial portion of carotid artery. No accurate studies have been accomplished in our country and some racial differences may exist. So we studied the angiographic findings in patients with carotid TIA.
METHODS
Thirty two patients with carotid TIA were included, but patients with non-atherosclerotic origin were excluded. MRI and MRA were checked simultaneously in all patients within 7 days after the last TIA. We evaluated the location, type and degree of the angiographic abnormalities and defined clinical factors related to the presence of vascular lesions. The criteria of significant abnormal findings were stenosis of more than 50%, ulceration or irregularity of carotid territory arteries contralateral to clinical symptoms.
RESULTS
Thirteen(40.6%) patients showed significant angiographic abnormalities related with the symptoms of TIA, and M1 portion of middle cerebral artery was the most frequent site, in 7 of 13 patients(53%). Patients with TIAs lasted less than 30 min.(P=0.011) and with TIAs occurred more than 4 times a day(P=0.029), had more frequent angiographic abnormalities. But there were no significant differences according to the presence of related acute cerebral infarction, gender and risk factors of stroke.
CONCLUSIONS
In our study, the prevalence of angiographic abnormality and the location of vascular lesion were concordant with the Japanese studies but quite different with the western studies, and we suggest that this may be due to differences in dietary life and race.