Dysphasia is associated with diffusion-weighted MRI abnormalities in patients with transient neurological symptoms
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ORIGINAL ARTICLE
Dysphasia is associated with diffusion-weighted MRI abnormalities in patients with transient neurological symptoms Zejin Jia 1 & Yangguang Song 2 & Wenli Hu 1 Received: 21 October 2019 / Accepted: 15 January 2020 # The Author(s) 2020
Abstract Background The clinical characteristics of diffusion-weighted imaging (DWI) abnormalities after transient neurological symptoms are of great significance for the early diagnosis and urgent intervention of transient ischemic attack (TIA). This study was aimed to investigate the clinical characteristics associated with acute DWI lesions in transient neurological symptoms. Methods We retrospectively recruited 302 patients with transient neurological symptoms. According to DWI findings, they were divided into DWI positive and DWI negative group. The clinical characteristics and the TIA-related scores such as ABCD2, ABCD3, ABCD3I, Dawson score, and the Diagnosis of TIA (DOT) score were compared between the two groups. Logistic regression analysis and receiver operating characteristic curves were used to identify the independent factors and compare the predictive value of different TIA scores for acute DWI lesions. Results A total of 302 patients were enrolled in this study. The mean age was 61.8 years, and 67.2% were male. We found 89 (29.5%) patients with DWI positivity. Logistic regression analysis showed the characteristic associated with DWI lesions was dysphasia (OR 2.226, 95% CI 1.220–4.062). The area under the curve for Dawson score and the DOT score was 0.610 (95% CI 0.543–0.678) and 0.625 (95% CI 0.559–0.691), respectively. Conclusion We found that DWI lesions were detected in 29.5% of patients with transient neurological symptoms and were associated with dysphasia. Dawson score and DOT score could have a higher predictability of DWI lesions in patients with transient neurological symptoms. Keywords Transient neurological symptoms . Diffusion-weighted imaging . Acute ischemic lesions . Dawson score . The Diagnosis of TIA score
Introduction A new tissue-based definition of transient ischemic attack (TIA) is a transient episode of focal neurological deficits consistent with cerebrovascular accident lasting less than 24 h and with the absence of a diffusion-weighted imaging (DWI) lesion detected by MRI [1–4]. TIA is treated as a medical emergency and may precede ischemic stroke that causes permanent neurological deficits. The stroke risk after TIA may be as high as 10% in the first week [5]. Identifying and treating patients * Wenli Hu [email protected] 1
Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
2
Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
with TIA is an effective way to prevent stroke [6]. DWI is a mandatory tool in the diagnosis of a TIA [7]. However, in many emergency settings, patients with transient neurological symptoms are difficult to have urgent brain MRI due to cost issues [8]. Several studies have shown that diffusion-weight
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