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Chapter 4 - Stroke Radiology

Published online by Cambridge University Press:  28 October 2019

Mary Carter Denny
Affiliation:
Georgetown University Hospital
Ahmad Riad Ramadan
Affiliation:
Henry Ford Hospital, Detroit
Sean I. Savitz
Affiliation:
University of Texas Health Science Center, Houston
James Grotta
Affiliation:
Memorial Hermann Texas Medical School
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Summary

Non-contrast CT (NCCT) of the head remains the standard procedure for the initial evaluation of stroke.

In the emergent initial evaluation of an acute stroke patient in the emergency department, NCCT remains the imaging modality utilized in most hospitals worldwide, with the exception of a few centers that have dedicated MRI capabilities for stroke. NCCT has the advantages of being widely available, relatively inexpensive, and fast to perform, but the disadvantages of radiation exposure and not being able to exclude stroke mimics such as complicated migraine and peripheral vertigo, as compared to MRI. The clinical presentation of a patient with an intracerebral hemorrhage can be indistinguishable from that of an ischemic stroke.

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Chapter
Information
Acute Stroke Care , pp. 32 - 57
Publisher: Cambridge University Press
Print publication year: 2019

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References

Hand, P, Wardlaw, J, Rowat, AM, et al. Magnetic resonance brain imaging in patients with acute stroke: feasibility and patient-related difficulties. J Neurology Neurosurg Psychiatry 2005; 76: 15251527.CrossRefGoogle ScholarPubMed
von Kummer, RBourquain, HBastianello, Set al. Early prediction of irreversible brain damage after ischemic stroke at CT. Radiology 2001; 219: 95100.Google Scholar
IST-3 Collaborative Group. Association between brain imaging signs, early and late outcomes, and response to intravenous alteplase after acute ischaemic stroke in the third International Stroke Trial (IST-3): secondary analysis of a randomised controlled trial. Lancet Neurol 2015; 14: 485496.CrossRefGoogle Scholar
Charidimou, A, Pasi, M, Fiorelli, M, et al. Leukoaraiosis, cerebral hemorrhage, and outcome after intravenous thrombolysis for acute ischemic stroke: a meta-analysis (v1). Stroke 2016; 47: 23642372.CrossRefGoogle ScholarPubMed
Barber, PA, Demchuk, AM, Zhang, J, Buchan, AM. Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group. Alberta Stroke Programme Early CT Score. Lancet 2000; 355: 16701674.Google Scholar
Hacke, W, Kaste, M, Fieschi, C, et al. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke: the European Cooperative Acute Stroke Study (ECASS). JAMA 1995; 274: 10171025.CrossRefGoogle ScholarPubMed
Hacke, W, Kaste, M, Fieschi, C, et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Lancet 1998; 352: 12451251.Google Scholar
Hacke, W, Kaste, M, Bluhmki, E, et al. Thrombolysis with alteplase 3 to 4∙5 hours after acute ischemic stroke. N Engl J Med 2008; 359: 13171329.Google Scholar
Álvarez-Sabín, J, Maisterra, O, Santamarina, E, Kase, CS. Factors influencing haemorrhagic transformation in ischaemic stroke. Lancet Neurol 2013; 12: 689705.Google Scholar
Powers, WJ, Rabinstein, AA, Ackerson, T, et al.; American Heart Association Stroke Council. 2018 guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2018; 49: e46e110.Google Scholar
Allmendinger, AM, Tang, ER, Lui, YW, et al. Imaging of stroke. Part 1, perfusion CT: overview of imaging technique, interpretation pearls, and common pitfalls. Am J Roentgenol 2012; 198: 5262.Google Scholar
Straka, MAlbers, GWBammer, R. Real-time diffusion–perfusion mismatch analysis in acute stroke. J Magn Reson Imaging 2010; 32: 10241037.Google Scholar
Calamante, FChristensen, SDesmond, PMet al. The physiological significance of the time-to-maximum (Tmax) parameter in perfusion MRI. Stroke 2010; 41: 11691174.CrossRefGoogle ScholarPubMed
Albers, GW. Use of imaging to select patients for late window endovascular therapy. Stroke 2018; 49: 22562260.CrossRefGoogle ScholarPubMed
Lewington, A, MacTier, R, Hoefield, R, et al. Prevention of contrast induced acute kidney injury (CI-AKI) in adult patients on behalf of the Renal Association, British Cardiovascular Intervention Society and the Royal College of Radiologists. https://renal.org/wp-content/uploads/2017/06/Prevention_of_Contrast_Induced_Acute_Kidney_Injury_CI-AKI_In_Adult_Patients-1.pdf (accessed May 2019).Google Scholar
Mueller, C, Buerkle, G, Buettner, HJ, et al. Prevention of contrast media associated nephropathy: randomised comparison of 2 hydration regimens in 1620 patients undergoing coronary angioplasty. Arch Intern Med 2002; 162: 329336.CrossRefGoogle ScholarPubMed
Weisbord, SD, Gallagher, M, Jneid, H, et al.; PRESERVE Trial Group. Outcomes after angiography with sodium bicarbonate and acetylcysteine. N Engl J Med 2018; 378: 603614.CrossRefGoogle ScholarPubMed
Thomalla, G, Simonsen, CZ, Boutitie, F, et al.; WAKE-UP Investigators. MRI-guided thrombolysis for stroke with unknown time of onset. N Engl J Med 2018; 379: 611622. doi:10.1056/NEJMoa1804355.CrossRefGoogle ScholarPubMed
Novotny, V, Thomassen, L, Waje‐Andreassen, U, Naess, H. Acute cerebral infarcts in multiple arterial territories associated with cardioembolism. Acta Neurolog Scand 2017; 135: 346351.CrossRefGoogle ScholarPubMed
Greenberg, SW, Charidimou, A. Diagnosis of cerebral amyloid angiopathy: evolution of the Boston criteria. Stroke 2018; 49: 491497.Google Scholar
Parizel, PM, Makkat, S, Van Miert, E, et al. Intracranial hemorrhage: principles of CT and MRI interpretation. Eur Radiol 2001; 11: 17701783.Google Scholar

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