Chih-Hsiang LiaoNien-Chen LiaoWen-Hsien ChenHung-Chieh ChenMing-Hong ChangYuang-Seng TsueiChiung-Chyi ShenShun-Fa YangPo-Lin Chen2026-01-302026-01-302020-05-0510.1097/JCMA.0000000000000342https://scholars.csmu.edu.tw/handle/123456789/4010<jats:sec> <jats:title>Background:</jats:title> <jats:p>A subgroup of patients with acute minor stroke (AMS) or transient ischemic attack (TIA) become disabled due to disease progression (DP) or recurrent stroke within 3 months. The aim of this article is to identify the risk factors for DP in AMS/TIA patients. In the literature, no studies focused on computed tomography perfusion (CTP) in AMS/TIA patients at the acute stage.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>This retrospective study included patients with AMS or TIA (onset of symptoms ≤4.5 hours, baseline National Institutes of Health Stroke Scale [NIHSS] score of 0-4). DP was defined as a deterioration of NIHSS score of ≥2 points during hospitalization or modified Ranking Scale ≥2 at 3-month follow-up. Clinical data and imaging results were retrieved and measured for statistical analysis.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>From 2011 to 2017, total 135 patients were eligible for further analysis: 28 patients (20.7%, DP group) and 107 patients (79.3%, non-DP group). The DP group had significantly higher larger penumbra volumes (<jats:italic toggle="yes">p</jats:italic> = 0.028). In univariate model of the logistic regression, patients with the following risk factors tended to have unfavorable outcome: female gender, higher HbA1c, chronic kidney disease stage ≥3b, intracranial atherosclerosis, and penumbra volume were associated unfavorable outcome, but larger deadcore volume was not. In further multivariate analysis, only penumbra volume &gt;5 cm<jats:sup>3</jats:sup> (<jats:italic toggle="yes">p</jats:italic> = 0.049, odds ratio [OR] = 3.21, 95% CI: 1.00-10.27) had the statistical significance. The cut-point value of the penumbra volume for unfavorable outcome in AMS/TIA patients was 4.73 cm<jats:sup>3</jats:sup>.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion:</jats:title> <jats:p>One fifth of the AMS/TIA patients had unfavorable outcome at 90 days. In CTP performed within 4.5 hours after the onset of AMS/TIA, the penumbra volume (&gt;5 cm<jats:sup>3</jats:sup>) was a significant risk factor for DP, and the cut-point value was 4.73 cm<jats:sup>3</jats:sup>. Further studies could be designed to involve this subgroup of patients for more aggressive treatment.</jats:p> </jats:sec>[SDGs]SDG5journal-article