Ischemic Stroke: Systematic Vascular Imaging from Head to Heart

Congress:

ECR 2018

Poster Number:

C-3132

Type:

Educational Exhibit

Keywords:

Education and training, Thrombolysis, MR, CT-Angiography, CT, Head and neck, CNS, Cardiovascular system, Ischaemia / Infarction

Authors:

A. V. Marinescu¹, A. Nicula², A. Marinescu², G. Iana²; ¹Bucuresti, România/RO, ²Bucharest/RO

DOI:

10.1594/ecr2018/C-3132

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-3132

Fig. 1: Stroke mechanism inspired by TOAST classification.

Fig. 2: NECT of stroke patients with cardioembolic suggestive patterns: (A) multiple...

Fig. 3: (A) NECT with multiple ischemic lesions in both anterior and posterior...

Fig. 4: (A) NECT showing acute (red arrow) and chronic (white arrows) ischemic lesions...

Fig. 15: F,41 NECT shows hyperdense right ICA compared with the left (A) and acute...

Learning objectives

Learning objectives: 1. To know the different etiologies of strokes 2. To showcase typical imaging findings of all etiologies 3. To know key points of evaluation for each etiology

Background

Stroke Stroke accounted for 11.8% of total deaths worldwide and is the second most common single cause of death in Europe, with great socio-economical impact, and constitutes a large part of emergency room (ER) presentations[1]. Stroke is caused by sudden insufficient blood flow to brain parenchyma and it can be divided into ischemic (which accounts for 85% of strokes) and hemorrhagic (which accounts for 15%). Ischemic stroke can be caused by occlusion of either small vessels in the brain or large arteries feeding the brain....

Findings and procedure details

Procedure Details: We reviewed the cases of patients with previously confirmed ischemic stroke of the past 2 years of the Department of Radiology and Medical Imaging of the University Emergency Hospital of Bucharest, selecting eloquent aspects for each pathology. The scanners used were a 16-row CT for emergencies, a 64-row CT for follow-up and a 1.5Tesla MRI. Findings: We divide findings according to the mechanism of stroke as seen in Fig. 1, inspired by TOAST classification [10]. Penetrating artery disease Lacunar ischaemic stroke is defined...

Conclusion

It is possible to investigate most ischemic stroke etiologies using CTA if one keeps in mind the needed parameters necessary to be assessed for each, thus providing an essential tool in secondary prevention.

Personal information

Contact Details: Dr. Andrei Victor MarinescuDepartment of Radiology and Medical Imaging, University Emergency Hospital of Bucharest, Bucharest,Splaiul Independenței 169, 050098University of Medicine and Pharmacy "Carol Davila", Bucharest email: [email protected]

References

1. Writing Group, M., et al., Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association. Circulation, 2017. 135(10): p. e146-e603. 2. Ferro, J.M., Cardioembolic stroke: an update. Lancet Neurol, 2003. 2(3): p. 177-88. 3. Niaz, A., et al., Recommendations from the ESO-Karolinska Stroke Update Conference, Stockholm 13–15 November 2016. European Stroke Journal, 2017. 2(2): p. 95-102. 4. Rafailidis, V., et al., Imaging of the ulcerated carotid atherosclerotic plaque: a review of the literature. Vol. 8. 2017. 1-13. 5. Lawson, M.F., et...