CT Scan Predicts Stroke After TIA

Jeff Perry, MD, MSc, CCFP-EM Associate Professor, Department of Emergency Medicine Senior Scientist, Ottawa Hospital Research Institute Research Chair in Emergency Neurological Research, University of Ottawa Emergency Physician, The Ottawa Hospital Epidemiology Program, F6 The Ottawa Hospital, Civic Campus Ottawa, OntarioMedicalResearch.com Interview with:
Jeff Perry, MD, MSc, CCFP-EM
Associate Professor, Department of Emergency Medicine
Senior Scientist, Ottawa Hospital Research Institute
Research Chair in Emergency Neurological Research, University of Ottawa Emergency Physician, The Ottawa Hospital
Epidemiology Program, The Ottawa Hospital, Ottawa, Ontario

Medical Research: What is the background for this study? What are the main findings?

Dr. Perry: Currently it is not well known which patients with a TIA or a non-disabling stroke will have a subsequent stroke or die within the days to weeks following their initial event.  This study found that patients with acute ischemia, especially if it is associated with an old infarction or microangiopathy, are at a much higher risk for an early subsequent stroke.

Medical Research: What should clinicians and patients take away from your report?

Dr. Perry:    Our study suggests that all patients with TIA or a non-disabling stroke should get urgent neuroimaging.  Traditionally this was suggested to rule out a hemorrhagic stroke or other etiology for a patients findings, but now our study has also demonstrated that identifying acute ischemia is also important.  Patients with acute ischemia, especially those with an old infarction or microangiopathy, need to be assessed by an experience stroke prevention physician, have further investigations and maximal stroke prevention therapies instituted right away to prevent subsequent stroke.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Perry: We will determine how best to incorporate the findings of this study into the previous ABCD2 and Canadian TIA Scores.  We will also assess the impact altering the referral patterns based on the CT findings on subsequent stroke rates.

Citation:

Computed Tomography Identifies Patients at High Risk for Stroke After Transient Ischemic Attack/Nondisabling Stroke: Prospective, Multicenter Cohort Study

Jason K. Wasserman, Jeffrey J. Perry, Marco L.A. Sivilotti, Jane Sutherland, Andrew Worster, Marcel Émond, Albert Y. Jin, Wieslaw J. Oczkowski, Demetrios J. Sahlas, Heather Murray, Ariane MacKey, Steve Verreault, George A. Wells, Dar Dowlatshahi, Grant Stotts, Ian G. Stiell, and Mukul Sharma

Stroke. 2014;STROKEAHA.114.006768published online before print December 4 2014, doi:10.1161/STROKEAHA.114.006768

 

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