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Perfusion MRI Abnormalities in Speech or Motor Transient Ischemic Attack Patients

Background and Purpose— Transient ischemic attack (TIA) patients may deteriorate rapidly. MRI is being increasingly used to assess such patients. One possible mechanism of neurological worsening is the presence of perfusion abnormalities. We sought to identify what proportion of TIA patients had evidence of perfusion abnormalities on MRI. Methods— TIA patients were prospectively enrolled and had a MRI completed as soon as possible. The images were assessed for the presence of perfusion abnormalities. Results— Sixty-nine TIA patients were enrolled, and 62 had perfusion imaging. In 56 patients (81%), the symptoms had resolved before imaging. In 21 patients (33.9%), there was evidence of a perfusion abnormality defined by relative mean transit time delay. In 12 patients (19.4%), the perfusion abnormality was present despite having complete resolution of neurological symptoms. We found no relationship between the presence of a perfusion abnormality and the clinical outcome. Conclusions— A proportion of TIA patients have perfusion abnormalities evident on MRI.