Lesion characteristics of transient ischemic attack with subcortical infarction distinct from lacunar stroke

Abstract

Background: In patients with transient ischemic attack (TIA), acute infarction was often found on diffusion-weighted magnetic resonance imaging. Infarcts associated with TIA typically have small lesion size, but it is unclear whether the lesion characteristics of TIA-related infarcts can be distinguished from those of lacunar stroke.Methods: Twenty-three patients with TIA with subcortical infarction (TSI) and 47 patients with lacunar stroke with subcortical infarction (LS) were analyzed. The size and relative location of infarcts in the corona radiata (CR) were compared between the two groups on diffusion-weighted imaging.Results: The location of LS was limited to the posterior portion (3/5) of the CR, whereas the location of TSI was distributed over the whole portion of the CR. While the lesion size of TSI located in the anterior half of the CR was similar to that of LS (63.5±16.3 mm2 vs. 63.9±33.1 mm2, p=0.96), the lesion size of TSI in the posterior half of the CR was smaller than that of LS (17.4±5.8 mm2 vs. 63.9±33.1 mm2, p<0.01).Conclusions: The results suggest that the lesion characteristics of TSI include noneloquent location in the anterior CR or very small (smaller than lacunar stroke) lesion size in the eloquent location of the posterior CR. TIA with subcortical infarction may be a distinct syndrome in clinical manifestations as well as in lesion characteristics distinguished from lacunar stroke.