title: Multiparametric Approach Enhances Detection of Patients with Cerebral TIAs at Risk of Stroke: A Prospective Pilot Case Series.
abstract: BACKGROUND
  Patients with transient ischemic attack (TIA) are generally clinically unstable, with fear of developing a handicapping stroke. Identification of those at highest and lowest risk of stroke in the first days and weeks after a TIA would allow appropriate use of worthy secondary prevention strategies.
  
  
  OBJECTIVE
  Incorporation of a clinical scoring system, neurovascular imaging, and magnetic resonance-diffusion-weighted imaging (MR-DWI) to help predicting risk of developing an ischemic stroke following a TIA.
  
  
  METHODS
  A prospective observational study was conducted on 25 patients with TIAs, 64% were females, and 26% were males, with a mean age of 57±10.36. Patients were assessed clinically and an ABCD(2) score was applied. Patients have undergone diffusion-weighted imaging (DWI), within 24 h from the event, and intra- and extracranial duplex study. Patients were followed up at intervals of one week, three months, six months, and one year.
  
  
  RESULTS
  Six patients (24%) developed stroke on their follow-up, most of them (83.3%) had their strokes within the first three months and had an initial ABCD(2) score of ≥4. The development of stroke was associated with the presence of significant extra and/or intracranial vessel disease (P=0.006) and the presence of acute lesions on their DWI (P=0.035).
  
  
  CONCLUSIONS
  Incorporation of brain MR-DWIs and neurovascular imaging together with the ABCD(2) score improves prediction of ischemic stroke following TIA.
authors.affiliation: Department of Neurology, Cairo University, Cairo, Egypt.
authors.forename: Foad
authors.initials: F
authors.lastname: Abd-Allah
authors.affiliation: Department of Neurology, Cairo University, Cairo, Egypt.
authors.forename: Tarek Zoheir
authors.initials: TZ
authors.lastname: Tawfik
authors.affiliation: Department of Neurology, Cairo University, Cairo, Egypt.
authors.forename: Reham Mohammed
authors.initials: RM
authors.lastname: Shamloul
authors.affiliation: Department of Neurology, Cairo University, Cairo, Egypt.
authors.forename: Montasser M
authors.initials: MM
authors.lastname: Hegazy
authors.affiliation: Department of Cardiology, Cairo University, Cairo, Egypt.
authors.forename: Assem
authors.initials: A
authors.lastname: Hashad
authors.affiliation: Department of Radiology, Cairo University, Cairo, Egypt.
authors.forename: Ayman Ismail
authors.initials: AI
authors.lastname: Kamel
authors.affiliation: Department of Neurology, Cairo University, Cairo, Egypt.
authors.forename: Dina
authors.initials: D
authors.lastname: Farees
authors.affiliation: Department of Neurology, Cairo University, Cairo, Egypt.
authors.forename: Nevin M
authors.initials: NM
authors.lastname: Shalaby
keywords: ABCD2 score; diffusion weighted image (DWI); neurovascular imaging; stroke risk; transient ischemic attack