Do all mini strokes show up on MRI?

As a medical professional with expertise in diagnostic imaging, I can provide you with an informed response regarding the detection of mini-strokes, also known as transient ischemic attacks (TIAs), on MRI scans. Not all mini-strokes will necessarily show up on an MRI. While MRI is a highly sensitive imaging tool that can detect changes in the brain associated with a stroke, the nature of a TIA is that it is a temporary blockage of blood flow to the brain. This blockage does not typically cause permanent damage, and therefore, the changes may not be visible on an MRI if the TIA is brief and the blood flow is restored quickly. However, there are specialized MRI techniques, such as diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI), which can be more sensitive to the acute changes that occur during a TIA. These advanced MRI sequences can sometimes detect small areas of ischemia even after the symptoms have resolved. It's also important to note that while a TIA may not always be evident on a standard MRI, other diagnostic tests like a CT angiogram or MR angiogram can be used to identify the affected blood vessel and the underlying cause of the TIA. In summary, while MRI is a powerful diagnostic tool, the transient nature of a TIA means that it might not always be detectable on a standard MRI. However, specialized MRI sequences and other imaging tests can be employed to provide a more comprehensive evaluation.

Tests will be done to rule out a stroke or other disorders that may cause the symptoms: You will likely have a head CT scan or brain MRI. A stroke may show changes on these tests, but TIAs will not. You may have an angiogram, CT angiogram, or MR angiogram to see which blood vessel is blocked or bleeding.