Type:
Educational Exhibit
Keywords:
Neuroradiology brain, MR, CT, Diagnostic procedure, Ischaemia / Infarction
Authors:
T. Hill, Y. Perchyonok, G. Fitt; Melbourne/AU
DOI:
10.1594/ranzcr2015/R-0108
Background
Stroke is a syndrome characterised by the acute onset of irreversible neurological deficit and may be ischaemic and/or haemorrhagic.
Due to the time critical nature of stroke treatment,
there is emphasis on rapid assessment and management of patients. Cerebrovascular imaging plays a crucial role in guiding treatment in the acute clinical setting.
Stroke mimics are conditions that have a stroke like presentation,
accounting for up to 30% of emergency department presentations,
where the provisional diagnosis was stroke.1-4
These include:
- toxic metabolic pathologies;
- seizure disorders;
- migraine;
- primary and secondary cerebral neoplasms;
- cerebral infections;
- demyelination;
- trauma;
- Posterior Reversible Encephalopathy Syndrome (PRES); and
- Transient Global Amnesia (TGA).
Identification of stroke mimics will help to minimise the cost and potential risks associated with stroke treatment.
Less common causes of infarction are an important subgroup with characteristic imaging features that point to a diagnosis.
These include:
- venous infarction/oedema
- cerebral amyloid angiopathy with lobar and sulcal subarachnoid haemorrhage;
- cerebral vasculitis;
- Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy (CADASIL);
- MoyaMoya; and
- Reversible Cerebral Vasoconstriction Syndrome.