Keywords:
Neuroradiology brain, CT
Authors:
I. Georgiou1, E. Tsokou2, A. ZOURLA2, S. Papakostas2, P. STAVRAKAS2, M. TSALIKIS2, A. N. Chalazonitis2; 1 ATHENS/GR, 2Athens/GR
DOI:
10.1594/ecr2011/C-1158
Methods and Materials
Brain CT findings of 192 patients examined for clinical symptoms of acute brain stroke were retrospectively studied.
All patients underwent an initial brain CT on the time of presenting to our Hospital and second CT 48 hours later.
Presence or absence of the following early signs was documented: hypoattenuating brain tissue,
obscuration of lentiform nucleus, dense middle cerebral artery (MCA),
“insular ribbon” sign,
loss of sulcal effacement.
Importantly,
hypoattenuation on CT is highly specific for irreversible ischemic brain damage,
if detected within first 6 hours.
These patients display larger infarct volumes,
more severe symptoms,
less favorable clinical courses and even have a greater risk of hemorrhage.
Obscuration of lentiform nucleus is one of the earliest and most frequently seen signs.
The basal ganglia are almost always involved in MCA-infarction.
“Insular Ribbon” sign is a very indicative and subtle early CT-sign of infarction in the territory of the MCA and dense MCA sign is a result of thrombus or embolus in the vessel.