Persisting perfusion defect in transient ischemic attacks: a new clinically useful subgroup?

Persisting perfusion defect in transient ischemic attacks: a new clinically useful subgroup?. Laloux, P., Jamart, J., Meurisse, H., De Coster, P., & Laterre, C. Stroke, 27(3):425–30, 1996.
abstract bibtex

BACKGROUND AND PURPOSE: Cerebral infarction and prolonged regional hypoperfusion have been described in patients with transient ischemic attacks (TIAs). The aim of this study was to compare the sensitivity of single-photon emission CT (SPECT) with that of brain CT and to evaluate the clinical signiﬁcance of diﬀerentiation of TIA patients with or without focal hypoperfusion. METHODS: From a hospital-based population, we studied the SPECT and CT ﬁndings in 76 consecutive patients, without a stroke history, who presented with TIA in the carotid artery territory. The recorded variables were the time of SPECT, imaging (\textless36 or \textgreater or = 36 hours), clinical presentation, history of previous TIA(s), duration of the presenting attack (\textless2 or \textgreater or = 2 hours), vascular risk factors, and etiology. We used both visual and semiquantitative analyses for the SPECT evaluation. Acetazolamide challenge was not performed. RESULTS: The overall SPECT sensitivity was 36% (27/76). When brain CT and SPECT were performed in the same patients, the SPECT sensitivity was signiﬁcantly higher than that of CT (19/59 [32%] versus 8/59 and 2 over black square]; [1 and 2 over black square]4%]; P=.007). The SPECT sensitivity was not dependent on the time of investigation, duration of attacks, history of TIA(s), or the clinical presentation. The vascular risk and etiologic factors were not signiﬁcantly diﬀerent between the patients with or without prolonged focal hypoperfusion. Logistic regression did not identify any variable to discriminate the two groups. CONCLUSIONS: Despite its better sensitivity compared with CT, SPECT performed without the acetazolamide test provides no additional clinically useful information on the vascular risk factors and etiology in TIA patients.

@article{laloux_persisting_1996,
	title = {Persisting perfusion defect in transient ischemic attacks: a new clinically useful subgroup?},
	volume = {27},
	abstract = {BACKGROUND AND PURPOSE: Cerebral infarction and prolonged regional hypoperfusion have been described in patients with transient ischemic attacks (TIAs). The aim of this study was to compare the sensitivity of single-photon emission CT (SPECT) with that of brain CT and to evaluate the clinical signiﬁcance of diﬀerentiation of TIA patients with or without focal hypoperfusion. METHODS: From a hospital-based population, we studied the SPECT and CT ﬁndings in 76 consecutive patients, without a stroke history, who presented with TIA in the carotid artery territory. The recorded variables were the time of SPECT, imaging ({\textless}36 or {\textgreater} or = 36 hours), clinical presentation, history of previous TIA(s), duration of the presenting attack ({\textless}2 or {\textgreater} or = 2 hours), vascular risk factors, and etiology. We used both visual and semiquantitative analyses for the SPECT evaluation. Acetazolamide challenge was not performed. RESULTS: The overall SPECT sensitivity was 36\% (27/76). When brain CT and SPECT were performed in the same patients, the SPECT sensitivity was signiﬁcantly higher than that of CT (19/59 [32\%] versus 8/59 and 2 over black square]; [1 and 2 over black square]4\%]; P=.007). The SPECT sensitivity was not dependent on the time of investigation, duration of attacks, history of TIA(s), or the clinical presentation. The vascular risk and etiologic factors were not signiﬁcantly diﬀerent between the patients with or without prolonged focal hypoperfusion. Logistic regression did not identify any variable to discriminate the two groups. CONCLUSIONS: Despite its better sensitivity compared with CT, SPECT performed without the acetazolamide test provides no additional clinically useful information on the vascular risk factors and etiology in TIA patients.},
	number = {3},
	journal = {Stroke},
	author = {Laloux, P. and Jamart, J. and Meurisse, H. and De Coster, P. and Laterre, C.},
	year = {1996},
	pages = {425--30},
}

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The recorded variables were the time of SPECT, imaging (\\textless36 or \\textgreater or = 36 hours), clinical presentation, history of previous TIA(s), duration of the presenting attack (\\textless2 or \\textgreater or = 2 hours), vascular risk factors, and etiology. We used both visual and semiquantitative analyses for the SPECT evaluation. Acetazolamide challenge was not performed. RESULTS: The overall SPECT sensitivity was 36% (27/76). When brain CT and SPECT were performed in the same patients, the SPECT sensitivity was signiﬁcantly higher than that of CT (19/59 [32%] versus 8/59 and 2 over black square]; [1 and 2 over black square]4%]; P=.007). The SPECT sensitivity was not dependent on the time of investigation, duration of attacks, history of TIA(s), or the clinical presentation. The vascular risk and etiologic factors were not signiﬁcantly diﬀerent between the patients with or without prolonged focal hypoperfusion. Logistic regression did not identify any variable to discriminate the two groups. CONCLUSIONS: Despite its better sensitivity compared with CT, SPECT performed without the acetazolamide test provides no additional clinically useful information on the vascular risk factors and etiology in TIA patients.","number":"3","journal":"Stroke","author":[{"propositions":[],"lastnames":["Laloux"],"firstnames":["P."],"suffixes":[]},{"propositions":[],"lastnames":["Jamart"],"firstnames":["J."],"suffixes":[]},{"propositions":[],"lastnames":["Meurisse"],"firstnames":["H."],"suffixes":[]},{"propositions":[],"lastnames":["De","Coster"],"firstnames":["P."],"suffixes":[]},{"propositions":[],"lastnames":["Laterre"],"firstnames":["C."],"suffixes":[]}],"year":"1996","pages":"425–30","bibtex":"@article{laloux_persisting_1996,\n\ttitle = {Persisting perfusion defect in transient ischemic attacks: a new clinically useful subgroup?},\n\tvolume = {27},\n\tabstract = {BACKGROUND AND PURPOSE: Cerebral infarction and prolonged regional hypoperfusion have been described in patients with transient ischemic attacks (TIAs). The aim of this study was to compare the sensitivity of single-photon emission CT (SPECT) with that of brain CT and to evaluate the clinical signiﬁcance of diﬀerentiation of TIA patients with or without focal hypoperfusion. METHODS: From a hospital-based population, we studied the SPECT and CT ﬁndings in 76 consecutive patients, without a stroke history, who presented with TIA in the carotid artery territory. The recorded variables were the time of SPECT, imaging ({\\textless}36 or {\\textgreater} or = 36 hours), clinical presentation, history of previous TIA(s), duration of the presenting attack ({\\textless}2 or {\\textgreater} or = 2 hours), vascular risk factors, and etiology. We used both visual and semiquantitative analyses for the SPECT evaluation. Acetazolamide challenge was not performed. RESULTS: The overall SPECT sensitivity was 36\\% (27/76). When brain CT and SPECT were performed in the same patients, the SPECT sensitivity was signiﬁcantly higher than that of CT (19/59 [32\\%] versus 8/59 and 2 over black square]; [1 and 2 over black square]4\\%]; P=.007). The SPECT sensitivity was not dependent on the time of investigation, duration of attacks, history of TIA(s), or the clinical presentation. The vascular risk and etiologic factors were not signiﬁcantly diﬀerent between the patients with or without prolonged focal hypoperfusion. Logistic regression did not identify any variable to discriminate the two groups. 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