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Title: Modern imaging : its role in prediction of outcome after stroke and TIA
Author: Coutts, Shelagh B.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2005
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In this work we look at some of the imaging methods available in the assessment of acute stroke; computerized tomography (CT), computerized tomography angiography (CTA), magnetic resonance imaging (MRI) including diffusion weighted imaging(DWI), perfusion weighted imaging(PWI) and magnetic resonance angiography (MRA) and sought to asses how they relate to clinical and imaging outcomes. We also sought to look closer at a population of minor stroke and TIA patients to attempt to predict which patients will have recurrent strokes. Alberta Stroke Program Early CT Score (ASPECTS) is a rating scale developed to semi-quantitatively assess damage in the Middle Cerebral Artery (MCA) territory which has been shown to be predictive of patient outcomes after thrombolysis. In this work we show that ASPECTS is a reliable scale when performed in real time. Minor stroke and TIA have a high rate of recurrent stroke, especially in the first 48 hours post the first event. In this work we look at some of the proposed mechanisms of deterioration in this population of patients including ischemic damage, vessel occlusion and perfusion abnormalities. In this work we found that the presence or absence of an acute DWI lesion on a acute MRI could be used to identify patients at high and low risk for recurrent events. We also show that in a population of patients with MCA occlusion and minor neurological deficits, all of these patients had an independent outcome at 3 months. We also identified that minor stroke and TIA have a high rate of asymptomatic lesions on follow up MRI at 1 month. Also, despite the fact that in many TIA patients their neurological symptoms have completely resolve, a high proportion of these patients show evidence of perfusion abnormalities on MRI.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available