scholarly journals Magnetic Resonance Imaging versus Computed Tomography in Transient Ischemic Attack and Minor Stroke: The More Υou See the More You Know

2013 ◽  
Vol 3 (1) ◽  
pp. 130-136 ◽  
Author(s):  
François Moreau ◽  
Negar Asdaghi ◽  
Jayesh Modi ◽  
Mayank Goyal ◽  
Shelagh B. Coutts
2017 ◽  
Vol 12 (8) ◽  
pp. 910-914 ◽  
Author(s):  
Kuan H Ng ◽  
Mukul Sharma ◽  
Oscar Benavente ◽  
Laura Gioia ◽  
Thalia S Field ◽  
...  

Rationale Patients with transient ischemic attack or minor stroke are at high risk of early recurrent cerebrovascular events. Anticoagulation with heparin or warfarin acutely after ischemic stroke is at least as efficacious as aspirin for preventing recurrent events but is associated with an increased risk of clinical worsening due to hemorrhagic transformation. Aim and hypothesis We aim to demonstrate the safety of early anticoagulation with dabigatran, an oral direct thrombin inhibitor, in acute cerebrovascular syndrome patients. The primary hypothesis is that symptomatic hemorrhagic transformation rates in dabigatran and aspirin-treated patients will be similar. Sample size estimates At least 136 participants in two groups required to demonstrate an absolute between-group difference in the rate of hemorrhagic transformation of 5.6% with 80% power, assuming alpha = 5%. Methods and design A randomized, multicenter open-label clinical trial (NCT02295826). Three-hundred participants with a transient ischemic attack/ischemic stroke (National Institutes of Health Stroke Scale ≤ 9) will undergo magnetic resonance imaging within 72 h of symptom onset and will be randomized to aspirin 81 mg daily or dabigatran 150 mg twice daily for 30 days. Participants undergo repeat magnetic resonance imaging at 30 days and clinical assessment to 90 days. Study outcomes The primary outcome is the symptomatic hemorrhagic transformation rate. Secondary outcomes include recurrent stroke and new ischemic lesions on repeat magnetic resonance imaging. Discussion This study will determine the safety of early anticoagulation with dabigatran in patients with acute transient ischemic attack/ischemic stroke and will inform the design of a phase III randomized trial aimed at demonstrating reduced recurrent early ischemic events after acute transient ischemic attack/stroke.


Stroke ◽  
2013 ◽  
Vol 44 (3) ◽  
pp. 671-674 ◽  
Author(s):  
François Moreau ◽  
Jayesh Modi ◽  
Mohammed Almekhlafi ◽  
Simer Bal ◽  
Mayank Goyal ◽  
...  

2005 ◽  
Vol 57 (6) ◽  
pp. 848-854 ◽  
Author(s):  
Shelagh B. Coutts ◽  
Jessica E. Simon ◽  
Michael Eliasziw ◽  
Chul-Ho Sohn ◽  
Michael D. Hill ◽  
...  

Stroke ◽  
2012 ◽  
Vol 43 (12) ◽  
pp. 3387-3388 ◽  
Author(s):  
Simerpreet Bal ◽  
Shiel K. Patel ◽  
Mohammed Almekhlafi ◽  
Jayesh Modi ◽  
Andrew M. Demchuk ◽  
...  

2019 ◽  
Vol 48 (1-2) ◽  
pp. 61-69 ◽  
Author(s):  
Tingting Zhu ◽  
Lingyu Li ◽  
Yulin Song ◽  
Yu Han ◽  
Chengshu Zhou ◽  
...  

Default mode network (DMN) is an important functional brain network that supports aspects of cognition. Stroke has been reported to be associated with functional connectivity (FC) impairments within DMN. However, whether FC within DMN changes in transient ischemic attack (TIA), an important risk factor for stroke, remains unclear. Forty-eight TIA patients and 41 age- and sex-matched healthy controls (HCs) were recruited in this study. Using resting-state functional magnetic resonance imaging seed-based FC methods, we examined FC alterations within DMN in TIA patients, tested its associations with clinical information, and further explored the ability of FC abnormalities to predict follow-up ischemic attacks. We found significantly decreased FC of left middle temporal gyrus/angular gyrus both with medial prefrontal cortex (mPFC) and posterior cingulate cortex/precuneus (PCC/Pcu) and significantly decreased FC among each pair of mPFC, left PCC, and right Pcu in patients with TIA as compared with HCs. Moreover, the connectivity between mPFC and left PCC could predict future ischemic attacks of the patients. Collectively, these findings may provide insights into further understanding of the underlying pathological mechanism in TIA, and aberrant FC between the hubs within DMN may provide a reference for the imaging diagnosis and early intervention of TIA.


Neurology ◽  
2012 ◽  
Vol 78 (Meeting Abstracts 1) ◽  
pp. P04.051-P04.051
Author(s):  
H. Zacharatos ◽  
A. Hassan ◽  
S. Chaudhry ◽  
A. Qureshi

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