To identify early CT and MR brain imaging findings of acute ischemic stroke and contraindications for thrombolysis in anterior circulation. To describe the usefulness of the different imaging modalities for the diagnosis and treatment of patients during an acute ischemic stroke. To review the attention times and patient flow in the imaging department during an acute ischemic stroke.
ABBREVIATIONS AHA: American Heart Association. ASA: American Stroke Association. ASPECTS: Alberta Stroke Programme Early CT Score. CNS: Central Nervous System. CT: Computed tomography. CVA: Cerebrovascular accident. ICA: Internal Carotid Artery. MCA: Middle Cerebral Artery. MR: Magnetic Resonance. mRs: Modified Rankin Score. NIHSS: National Institute of Health Stroke Scale. rt-PA: Recombinant tissue Plasminogen Activator. TBI: Traumatic Brain Injury. The autors deny any conflict of interest...
Findings and procedure details
DIAGNOSIS In the next image,
you will find the advantages and diasadvantages of the different imaging modalities in acute ischemic stroke. Fig 1 EARLY FINDINGS OF ACUTE ISCHEMIC STROKE COMPUTED TOMOGRAPHY CT Head without contrast (w/o C) It allows to classify the CVA in hemorrhagic or ischemic. EARLY SIGNS OF ISCHEMIA CVA IN CT HEAD WITHOUT CONTRAST ARE: Loss of gray-white matter differentiation. Hyperdense artery (Hyperdense MCA and "Dot" sign) [4,5,8]. Fig 2-4 Important tips The sign is...
Imaging plays a fundamental and determinant role in the care of patient with acute ischemic stroke,
for the diagnosis,
treatment and follow up.
CT and MR are useful,
which one to be used should be determined according to local factors.
Each modality of image has advantages and disadvantages that should be taken into account,
to choose the image modality for each patient,
according to the time of symptoms onset.
Posterior circulation stroke are evaluated differently. The knowledge of the...
An updated definition of Stroke for the 21st century; Stroke.
Handb Clin Neurol.
2016; 138:239-61. 3.
Thresholds in cerebral ischemia- the ischemic penumbra.
1981; 12:723-725 4.
Hyperdense middle cerebral artery sign is an omnious prognostic marker despite optimal workflow.
Acta neurol Scand.