Type:
Educational Exhibit
Keywords:
CNS, CT-Angiography, MR, Education, Ischaemia / Infarction
Authors:
J. Sison, C. Shin, A. Pillai, A. Malhotra, M. Emin Adin, L. Tu
DOI:
10.26044/ranzcr2023/C-51
Imaging findings OR Procedure details
Prompt diagnosis of posterior circulation (PC) stroke is essential. Patients treated within the “stroke window” with thrombolysis may demonstrate improved neurologic outcomes. Common imaging paradigms for suspected stroke in either the anterior or posterior circulation consist of non-contrast computed tomography of the head to exclude intracranial hemorrhage, as well as CT angiography (CTA) to evaluate for the presence of large vessel occlusion (LVO). CTA findings are a key factor in determining which patients are eligible for mechanical thrombectomy, while additional data from CT perfusion aids in the selection of good candidates for thrombectomy. Magnetic resonance imaging (MRI) generally offers greater sensitivity and specificity for infarct detection, with potential use for perfusion-weighted imaging (PWI) in penumbra detection and characterization. While much attention has been given to these techniques with regards to anterior circulation stroke, literature regarding their applications to PC stroke is limited. Here, we will discuss each modality in the context of PC stroke, as well as emerging technologies in each category. Our goal is to equip radiologists to summarize existing evidence regarding the evaluation of suspected PC stroke.