Neuroimaging
TIA, swelling, ischaemic stroke, Stroke, stroke, IST-3, haemorrhage, trialAcute stroke lesions, atrophy, white matter lucencies, cerebral atrophy, ischaemia, lucency
STROKE, ISCHAEMIC STROKE, STROKE, BRAIN, HAEMORRHAGE, CORTEX, ATROPHY, CEREBRAL ATROPHY, ISCHAEMIA, TIA
Brain imaging was essential for all ischaemic stroke patients prior to enrolment in TARDIS in order to exclude haemorrhage or an alternative imaging diagnosis. Imaging was not essential for patients with TIA. Computerised topography (CT) or magnetic resonance imaging (MRI) scans performed according to local practice and any additional clinical scans were collected and adjudicated centrally by a trained panel of expert neuroradiologists blinded to symptoms and randomised treatment, using approaches developed from the third international stroke trial (IST-3) and the efficacy of nitric oxide in stroke (ENOS) trialAcute stroke lesions were graded by location, size, severity, swelling and mass effect. The Alberta Stroke Program Early CT Score (ASPECTS) was used to grade the degree of ischaemia affecting the middle cerebral artery territory.Baseline pre-event imaging markers including cerebral atrophy, periventricular white matter lucencies and old vascular lesion(s) were assessed individually, and amalgamated as a ‘brain frailty’ scoreCerebral atrophy: assessed in cortical and central regions as 0 = absent, 1 = moderate, 2 = severe.Periventricular white matter lucencies: assessed in anterior and posterior regions as 0 = absent, 1 = lucency restricted to region adjoining ventricles, 2 = lucency covering lateral ventricle to cortex.Old vascular lesions: assessed by location.‘Brain frailty’ score: 1 point for periventricular white matter lucencies (score of 1 or 2 anterior and/or posterior); 1 point for cerebral atrophy (scores of 1 or 2 cortical and/or central); and 1 point for old vascular lesion(s) (maximum 3 of 3).