-To explain the role of Radiology in Acute Ischemic Stroke.
-To determine an appropriate imaging protocol in the emergency room for acute stroke evaluation: non-enhanced CT,
CT angiography and CT perfusion.
-To provide a systematic reading and elaboration of a structured radiological report that help the neurologist to make a therapeutic decision.
Stroke can be defined as an acute central nervous system injury with an abrupt onset,
and is the third leading cause of mortality in developed countries,
and also a major cause of morbidity.
It is a syndrome caused by disruption of the blood flow to part of the brain.
-Risk factors of stroke: high blood pressure (the most important one),
- Hemorrhagic stroke (15%): rupture of a blood vessel,
with injury to cells and sudden loss...
Findings and procedure details
The three “key questions” the radiologist have to answer…
- Is it hemorrhage or ischemic stroke? -> Non-enhanced CT
- Is there a large vessel occlusion? -> CT angiography
- Is there salvageable tissue? -> clinical picture,
-5mm section thickness parallel to the inferior orbitomeatal line,
from skull base to vertex.
Detection of hemorrhage = the key role of nonenhanced CT
Detection of other possible mimics of stroke (Neoplasia,
every second counts.
In the multidisciplinary management of these patients,
the radiologist is essential for both diagnosis and treatment.
It is indispensable to know the stroke protocol,
to keep a systematic reading and to elaborate a structured report that help to select an appropriate therapy.
Marco de Lucas E et al.
CT Protocol for Acute Stroke: Tips and Tricks for General Radiologists.
RadioGraphics 2008; 28:1673–1687.
Mendigaña Ramos M et al.
Evaluación vascular en el código ictus: papel de la angio-tomografía computarizada.
Bártulos AV et al.
TC multimodal en el diagnóstico del código ictus.
González A et al.
Disección arterial cervico-cerebral.
Arch Neurocien (Mex) 2009.
GG Gasparian et al Imaging of occlusive thrombi in acute...