Type:
Educational Exhibit
Keywords:
Neuroradiology brain, Vascular, Interventional vascular, CT, CT-Angiography, CT-Quantitative, Technical aspects, Diagnostic procedure, Computer Applications-Detection, diagnosis, Acute, Ischaemia / Infarction
Authors:
E. Montes Figueroa1, E. Marín Diez1, Y. Lamprecht1, A. B. Barba Arce2, E. G. HERRERA ROMERO1, F. Pozo Piñon3, E. M. Marco De Lucas4; 1Santander/ES, 2Torrelavega, Cantabria/ES, 3Santander, Cantabria/ES, 4Santander, Ca/ES
DOI:
10.1594/ecr2018/C-1733
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 the diagnosis 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 CT is able to detect intra-arterial thrombi,
and may even give information on its composition.
Series shows that every 45-minute delay in angiographic reperfusion reduced the likelihood of good clinical outcome by 8-38% and each 1-hour delay to reperfusion was associated with a less favorable degree of disability and less functional independence.
Every passing minute,
1.9 million neurons,
14 billion synapses,
and 12 km of myelinated fibers are destroyed in the territory of occluded artery.
The main challenges when interpreting a stroke protocol could include the following:
1.
To make the code to wait
2.
To not be prepared for the arrival of the code
3.
Non enhanced CT
4.
Perfusion CT
5. CT angiography (CTA)
6.
Acquisition pitfalls
7.
Interpretation pitfalls
8.
Acute ischemia chameleons
9.
Hyperperfusion
10.
Improper correlation perfusion-CTA