title: Magnetic resonance imaging correlates of transient cerebral ischemic attacks.
abstract: OBJECTIVE
  MRI of patients with a transient ischemic attack (TIA) may provide more detailed morphological insights than CT. We therefore studied the frequency and type of TIA-related infarcts shown by MRI, examined the utility of intravenous contrast material, and searched for potential predictors of infarct occurrence.
  
  
  METHODS
  We performed 1.5-T MRI of the brain of 52 patients (age range, 28 to 93 years; mean, 61 years) with a hemispheric TIA. Contrast material (Gd-DTPA) was given to 45 individuals. We recorded type, number, size, and location of ischemic brain lesions and related the presence of acute infarction to features of clinical presentation and probable causes for the TIA.
  
  
  RESULTS
  MRI showed focal ischemic lesions in 50 patients (81%), but an acute TIA-associated infarct was seen in only 19 subjects (31%). In patients with an acute lesion, the infarcts were smaller than 1.5 cm in 13 (68%), purely cortical in 11 (58%), and multiple in 7 (37%) individuals. Contrast enhancement contributed to the delineation of an acute lesion in only 2 of 45 patients (4%). Acute infarction was unpredictable by clinical TIA features, but the frequency of identifiable vascular or cardiac causes was significantly higher in those patients with TIA-related morphological damage (odds ratio, 5.2 [95% confidence interval, 1.6 to 17.3]).
  
  
  CONCLUSIONS
  More than two thirds of TIA patients showed no associated brain lesion even when MRI and contrast material were used, but the overall frequency of ischemic damage was high. TIA-related infarcts on MRI were mostly small and limited to the cortex and tended to consist of multiple lesions. A positive MRI underscores the need for comprehensive diagnostic workup since evidence of infarction appears to be associated with a higher frequency of significant vascular or cardiac disorders.
authors.affiliation: Department of Neurology, Karl-Franzens University, Graz, Austria.
authors.forename: F
authors.initials: F
authors.lastname: Fazekas
authors.forename: G
authors.initials: G
authors.lastname: Fazekas
authors.forename: R
authors.initials: R
authors.lastname: Schmidt
authors.forename: P
authors.initials: P
authors.lastname: Kapeller
authors.forename: H
authors.initials: H
authors.lastname: Offenbacher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000473:pathology; D016001:Confidence Intervals; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA