title: Cerebral microbleeds and early recurrent stroke after transient ischemic attack: results from the Korean Transient Ischemic Attack Expression Registry.
abstract: OBJECTIVE
  The risk of early recurrent stroke after transient ischemic attack (TIA) may be modifiable by optimal treatment. Although ABCD2 scores, diffusion-weighted imaging lesions, and large artery stenosis are well known to predict early stroke recurrence, other neuroimaging parameters, such as cerebral microbleeds (CMBs), have not been well explored in patients with TIA.
  
  
  OBJECTIVE
  To determine the rate of early recurrent stroke after TIA and its neuroimaging predictors.
  
  
  METHODS
  In this hospital-based, multicenter prospective cohort study, consecutive patients with TIA were enrolled from 11 university hospitals from July 1, 2010, through December 31, 2012. Patients who were admitted within 24 hours after symptom onset and underwent diffusion-weighted imaging were included.
  
  
  METHODS
  The primary end point was recurrent stroke within 90 days. Baseline demographics, clinical manifestations, neuroimaging findings, and use of antithrombotics or statins also were analyzed.
  
  
  RESULTS
  A total of 500 patients (mean age, 64 years; male, 291 [58.2%]; median ABCD2 score, 4) completed 90-day follow-up with guideline-based management: antiplatelets (457 [91.4%]), anticoagulants (74 [14.8%]), and statins (345 [69.0%]). Recurrent stroke occurred in 25 patients (5.0%). Compared with patients without recurrent stroke, those with recurrent stroke were more likely to have crescendo TIA (20 [4.2%] vs 4 [16.0%], P = .03), white matter hyperintensities (146 [30.7%] vs 13 [52.0%], P = .03), and CMBs (36 [7.6%] vs 7 [28.0%], P = .003). On multivariable Cox proportional hazards analysis, CMBs remained as independent predictors for recurrent stroke (hazard ratio, 3.66; 95% CI, 1.47-9.09; P = .005).
  
  
  CONCLUSIONS
  Immediate and optimal management seems to modify the risk of recurrent stroke after TIA. Cerebral microbleeds may be novel predictors of stroke recurrence, which needs further validation.
authors.affiliation: Department of Neurology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Jae-Sung
authors.initials: JS
authors.lastname: Lim
authors.affiliation: Department of Neurology, Ilsan Paik Hospital, Inje University, Goyang, Republic of Korea.
authors.forename: Keun-Sik
authors.initials: KS
authors.lastname: Hong
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Gyeong-Moon
authors.initials: GM
authors.lastname: Kim
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Oh Young
authors.initials: OY
authors.lastname: Bang
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Hee-Joon
authors.initials: HJ
authors.lastname: Bae
authors.affiliation: Department of Neurology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Hyung-Min
authors.initials: HM
authors.lastname: Kwon
authors.affiliation: Department of Neurology, Eulji General Hospital, Eulji University, Seoul, Republic of Korea.
authors.forename: Jong-Moo
authors.initials: JM
authors.lastname: Park
authors.affiliation: Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Seung-Hoon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Neurology, Inha University Hospital, Incheon, Republic of Korea.
authors.forename: Joung-Ho
authors.initials: JH
authors.lastname: Rha
authors.affiliation: Department of Neurology, Catholic University, St Mary's Hospital, Seoul, Republic of Korea.
authors.forename: Jaseong
authors.initials: J
authors.lastname: Koo
authors.affiliation: Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
authors.forename: Kyung-Ho
authors.initials: KH
authors.lastname: Yu
authors.affiliation: Department of Neurology, Korea University Guro Hospital, Seoul, Republic of Korea.
authors.forename: Woo-Keun
authors.initials: WK
authors.lastname: Seo
authors.affiliation: Department of Neurology, Soonchunhyang University Hospital, Seoul, Republic of Korea.
authors.forename: Kyung Bok
authors.initials: KB
authors.lastname: Lee
authors.affiliation: Department of Neurology, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
authors.forename: Yong-Seok
authors.initials: YS
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors