22. European Stroke Conference 574 © 2013 S. Karger AG, Basel Scientific Programme 17 Acute cerebrovascular events (ACE): TIA and minor strokes Are diffusion negative stroke syndromes really ischemic? S.P. Adatia1, J. Modi2, M. Goyal3, A.M. Demchuk4, S.B. Coutts5 Foothills medical hospital, University of Calgary, Calgary, CANADA1, Foothills medical hospi-tal, University of Calgary, Calgary, CANADA2, Foothills medical hospital, University of Calgary, Calgary, CANADA3, Foothills medical hospital, University of Calgary, Calgary, CANADA4, Foot-hills medical hospital, University of Calgary, Calgary, CANADA5 Introduction: The sensitivity of diffusion weighted imaging (DWI) sequence in MRI brain for acute cerebrovas-cular ischemia is high. Recent literature has highlighted microbleeds (MBs) as a potential cause for stroke syndromes. In this study we assessed the proportion of TIA and minor stroke patients who were DWI negative, and have MBs that could potentially explain the presenting symptoms. Methods: Patients were identified from the CATCH study. The CATCH study was a prospective imaging study in TIA and minor stroke (NIHSS<4). Patients having negative DWI who completed gradient echo (GRE) sequences were included in this substudy. Images were reviewed simultaneously by a neu-roradiologist and stroke neurologist. Microbleed location was noted and correlated to the clinical information regarding the presenting event. Results: Out of 420 patients, 23 patients had DWI negative scans and positive GRE. 3/23 (13.04%) had MBs in a location potentially corresponding to the location of the stroke syndrome. All patients had tran-sient symptoms. All 3 patients had varying episodes of aphasia. One patient with expressive aphasia had a MB in the left frontal gyrus. Another with receptive aphasia had a MB in the left inferior pari-etal lobe. The third patient with global aphasia had a MB in the left frontal gyrus. No MBs in other regions were identified in these patients. There was no obvious alternative explanation for the symp-toms in any of these patients. Conclusions: In a small proportion of patients presenting with transient neurological deficits we have identified cortical or deep microbleeds as a potential cause for the symptoms. In unexplained clinical syn-dromes with negative DWI, using a GRE sequence to look for microbleeds might be helpful. This challenges the traditional view that microbleeds are silent. Further studies are warranted to deter-mine the age of microbleeds as this might help prove their relevance.
Karger_ESC London_2013
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