Magnetic resonance imaging for transient ischaemic attacks and minor strokes: a retrospective cross-sectional study

Transient ischaemic attacks (TIAs) and minor strokes are common, with a high risk of an early recurrence. Short duration episodes pose a diagnostic challenge as their symptomatology can be similar to conditions such as migraines with auras, partial seizures or functional disorders. Diffusion-perfusion magnetic resonance imaging(MRI) can identify acute ischaemic lesions in about half of the patients with TIAs. However, a significant percentage will still have a non-diagnostic scan resulting in further uncertainty. The aim of this study was to assess the following parameters: (a) clinical presentation; (b) radio-logical findings; (c) initial diagnosis; and (d) final diagnosis. Method: This was a retrospective cross-sectional study of all patients that underwent MRI scanning, between March and October 2011, as part of their clinical assessment in Aberdeen Royal Infirmary. Results: Overall, 69 patients with an age range between 23 and 84 years (median: 51; interquartile range: 13) were scanned. The most common presenting complaint was sensory and motor impairment. Infarction was observed in 22 scans, whereas no radiological abnormalities were noted for 17 patients. Interestingly, 29 scans had evidence of white matter hyperintensities. The most frequent diagnosis before scanning was minor stroke and after scanning it was migraine. In 61% (42/69) of the cases, however, the diagnosis did not change. Conclusion: The above-mentioned findings suggest that there is still diagnostic uncertainty when it comes to TIAs and minor strokes. Thus, the use of new and advanced MRI modalities should be explored with the aim of developing more sensitivity imaging biomarkers.