ESOC 2025 | The clinical relevance of perfusion-weighted MRI findings following a TIA
Philipp Bücke, MD, MSc, University Hospital Bern, Bern, Switzerland, discusses the clinical relevance of perfusion-weighted magnetic resonance imaging (MRI) findings following a transient ischemic attack (TIA). He highlights evidence suggesting that hyperperfusion on brain imaging may indicate an elevated risk of subsequent stroke. Dr Bücke underscores the importance of accurately identifying the underlying cause of perfusion abnormalities and stresses the need for inpatient care and comprehensive diagnostic workup to guide management and reduce the risk of recurrent stroke. This interview took place at the 11th European Stroke Organisation Conference (ESOC) in Helsinki, Finland.
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Transcript
In this point we have to look at the reason for the perfusion deficit. It might be like an old defect in the brain from a stroke before or it might be like a stenosis of the cervical arteries for example and I’m just looking at the cause of the hyperperfusion it might of course lead us to sort of different decision making for example I think it should be like an inpatient treatment for a stroke and we should actually look at the vessels...
In this point we have to look at the reason for the perfusion deficit. It might be like an old defect in the brain from a stroke before or it might be like a stenosis of the cervical arteries for example and I’m just looking at the cause of the hyperperfusion it might of course lead us to sort of different decision making for example I think it should be like an inpatient treatment for a stroke and we should actually look at the vessels. Is there a need for example for like vascular surgery or for like a stenting of the internal carotid artery if that is the case. And if you just don’t know the cause of the hyperperfusion it’s also like sort of an inpatient treatment which would be necessary as our study showed that there is an increased or suggested that there is an increased risk of stroke after TIA if there is a hyperperfusion on brain imaging. This should be treated in an inpatient setting, we should do a thorough workup for causes of TIA or stroke and of course this would also require more strict follow-up, meaning follow-up in our outpatient department or any other outpatient department and also doing follow-up imaging for example.
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