Learning objectives
To describe the most frequent mistakes observed using the multimodal Computed Tomography (CT) study performed for acute stroke to evaluate and analyze how to avoid them by establishing a well-organized protocol to follow.
Background
The stroke is one of the main causes of morbidity and mortality on developed countries.
As a generic term,
stroke is described as a sudden onset of a neurological deficit.
The multimodal CT and the Magnetic Resonance (MRI) can help to establish thediagnosis of the stroke and besides to give a general idea of the vascular composition and the cerebral perfusion.
Causes:
- Ischemic (80%)
- Hemorrhagic (~ 20%)
- Non-vascular (<1%)
Timely treatment is essential for the success of an acute ischemic stroke.
The...
Findings and procedure details
A.
Organization Pitfalls
a) To make the code to wait.
There are different protocols for stroke management,
most of them agree that the first 12 hours from the onset of symptoms are essential for treatment and prognosis.
Delaying the start of treatment in any of the different steps,
either intra and extra-hospital,
little clinical suspicion,
atypical presentations of stroke,
(series determine that up to 4% of acute strokes are ruled out due to low clinical signs) or simply failures of the different links that make...
Conclusion
Prompt and accurate diagnosis is crucial in the acute ischemic strokecare.
A systematic CT protocol acquisition and evaluation is necessaryin order to avoid possible pitfalls and mistakes.
References
1 Lucas,
E.,
Sánchez,
E.,
Gutiérrez,
A.,
Mandly,
A.,
Ruiz,
E.,
Flórez,
A.,
Izquierdo,
J.,
Arnáiz,
J.,
Piedra,
T.,
Valle,
N.,
Bañales,
I.
and Quintana,
F.
(2008).
CT Protocol for Acute Stroke: Tips and Tricks for General Radiologists.RadioGraphics,
28(6),
pp.1673-1687.
2 Heit,
J.
and Wintermark,
M.
(2016).
Perfusion Computed Tomography for the Evaluation of Acute Ischemic Stroke.Stroke,
47(4),
pp.1153-1158.
3 Dupre,
C.,
Libman,
R.,
Dupre,
S.,
Katz,
J.,
Rybinnik,
I.
and Kwiatkowski,
T.
(2014).
Stroke Chameleons.Journal of Stroke and Cerebrovascular Diseases,
23(2),
pp.374-378.
4 Allmendinger,...