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 related directly or indirectly to the constitution and research process in the cerebrovascular disease center of the Fundacion Santa Fe de Bogota Univeristy Hospital.
No direct promotion of research,
intellectual property rights or financial support of any kind influences the concepts expressed in this academic presentation.
INTRODUCTION
The AHA/ASA defines the stroke as a neurological deficit attributed to an acute focal injury of the CNS,
usually focal,
transient or permanent by a vascular cause,
including cerebral infarction,
intracerebral hemorrhage and subarachnoid hemorrhage.
[1]
The Stroke Code is an emergency call that activates a quick response multidisciplinary group of health professionals (Diagnostic and interventional radiologists,
neurologists,
neurosurgeons,
anesthesiologists,
emergency and intensive care physicians,
among others) to treat patients with acute ischemic stroke.
Objective of the code: Early identification of a candidate for IV thrombolysis or endovascular thrombectomy to decrease the risk of cerebral tissue infarction (core and penumbra) in an affected vascular territory.
Infarct core: Irreversibly damged brain tissue.
Penumbra: Functionally impaired yet still viable tissue surrounding the ischemic core.
Evaluation objectives:
To rule out thrombolysis contraindications
To discard deseases that resemble ischemia
To identify thrombolysis candidates
Evaluate the arteries,
infarct core,
penumbra and collaterals
Diagnostic imaging plays an active and fundamental role for diagnosis,
treatment and follow-up of stroke.
EPIDEMIOLOGY
Ischemic stroke is classified according to their cause as ischemic (80%) or hemorrhagic (20%) and is considered an important public health problem due to their high morbidity and mortality.
Worldwide,
15 million people suffer a stroke each year.
Almost 6 million die yearly.
Another 5 million remain with permanent disability.
Stroke is the second cause of disability after dementia.
Stroke is the second cause of death among people over 60 years.
Stroke is the fifth cause of death among people aged 15 to 59 years.
[2]
In this academic exhibition,
we will explain the importance of imaging in acute ischemic stroke of anterior circulation.
Ischemic events that occur in the posterior circulation requiere a different aproach,
and will not be included in this academic exhibition.