Objective  To explore value of cerebrovascular reserve (CVR) capability in evaluating risk of secondary stroke in patients with frequent transient ischemic attack (TIA).

  Methods  A total of 86 patients with frequent TIA were selected and conducted with comprehensive treatments according to recommended methods of TIA treatment guidelines. After one year of follow up, the patients were divided into stroke group and non-stroke group according to the occurrence of secondary stroke, and transcranial Doppler (TCD) combined with CO₂ inhalation test was used to evaluate the changes of CVR, blood perfusion index (PI) and mean cerebral artery blood volume (MCV) before and after treatment in both groups. Multivariate Logistic regression analysis was used to analyze the risk factors of secondary stroke in TIA patients, and the Receiver Operating Characteristic (ROC) curve was drawn to evaluate the predictive value of CVR for secondary stroke.

  Results  One year follow-up showed that 24 patients had secondary stroke and 62 patients had no secondary stroke. After treatment, CVR and MCV in both groups were significantly higher than those before treatment, while PI was significantly lower than that before treatment (P < 0.05). After treatment, CVR of the stroke group was significantly lower than that of the non-stroke group (P < 0.05), but PI and MCV showed no significant differences between the two groups (P>0.05). Multivariate Logistic regression analysis showed that CVR was the influencing factor of secondary stroke in patients with frequent TIA (OR= 3.219, P=0.011). ROC analysis showed that the accuracy, sensitivity and specificity of CVR in predicting the risk of secondary stroke were 84.6%, 87.6%and 75.3% respectively.

  Conclusion  CVR is closely related to the risk of secondary stroke in patients with frequent TIA, which can be used as an important quantitative index to predict the risk of stroke.