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Review
. 2022 Dec;12(12):e2780.
doi: 10.1002/brb3.2780. Epub 2022 Nov 9.

Neuroimaging for differential diagnosis of transient neurological attacks

Ying Wang  1 , Hao Zha  2
Affiliations
Review

Neuroimaging for differential diagnosis of transient neurological attacks

Ying Wang et al. Brain Behav. 2022 Dec.

Abstract

Background: Rapid yet comprehensive neuroimaging protocols are required for patients with suspected acute stroke. However, stroke mimics can account for approximately one in five clinically diagnosed acute ischemic strokes and the rate of thrombolyzed mimics can be as high as 17%. Therefore, to accurately determine the diagnosis and differentiate mimics from true transient ischemic attacks, acute ischemic stroke is a challenge to every clinician.

Discussion: Medical history and neurological examination, noncontract head computed tomography, and routine magnetic resonance imaging play important roles in the assessment and management of patients with transient neurological attacks in the emergency department. This review attempts to summarize how neuroimaging can be utilized to help differentiate the most common mimics from transient ischemic attack and acute ischemic stroke.

Conclusion: Although imaging can help direct critical triage decisions for intravenous thrombolysis or endovascular therapy, more detailed medical history and neurological examination are crucial for making a prompt and accurate diagnosis for transient neurological attack patients.

Keywords: acute ischemic stroke; computed tomography; magnetic resonance image; transient and neurological attack; transient ischemic attack.

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Conflict of interest statement

All authors have completed the ICMJE uniform disclosure form. The authors have no conflicts of interest to declare.

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