Eligibility Criteria- INCLUSION CRITERIA:
- Age greater than or equal to 18
- Have been admitted to one of the study sites for evaluation of stroke-like symptoms ( qualifying event ) such as difficulty moving or speaking, blurred vision, dizziness or balance issues; and had an MRI scan. Symptoms must be attributable to a stroke or TIA with no other definitive cause identified at the time of screening.
- Provides written informed consent prior to study participation OR is able to provided assent and consent is provided by a qualifying LAR.
- Is willing to return to one of the two study sites to initiate serial study visits between 3-4 months whenever possible, but could be up to 6 months from the qualifying event and continue participation for at least one year.
Is willing to appoint a Durable Power of Attorney (DPA) for NIH research
An individual who meets any of the following criteria will be excluded from this study:
- Medical contraindications for MRI (e.g., any non-organic implant or other device such as a cardiac pacemaker or infusion pump or other metallic implants, objects, or body piercings that are not MRI-compatible or cannot be removed)
- Psychological contraindications for MRI (e.g., claustrophobia), to be assessed at the time the medical history is collected
- If unable to lie comfortably on their back for up to 1 hour.
- Contraindication to gadolinium (pregnant or nursing, previous allergic reaction, renal insufficiency)
- Known diagnosis that is thought to be the cause of their WMH (e.g. multiple sclerosis) other than chronic cerebrovascular disease, cerebral autosomal dominant arteriopathy with subcortical infarcts (CADASIL), or migraine.
- Clinically significant medical or neurological disorders that might expose the patient to undue risk of harm, confound study outcomes or prevent the participant from completing the study; examples of such conditions include but are not limited to respiratory compromise, cardiovascular instability or cerebral edema.
- History of an ongoing seizure disorder, structural brain abnormality or nonvascular brain injury.
- Unlikely to be released from the hospital following the qualifying event or has severe disability preventing ambulation or verbal communication.
- Known malignant disease or other chronic illness with poor 5-year prognosis other than dementia.
- Attaining a MoCA score less than or equal to 13 during screening assessment.