Abstract
Stroke is a leading cause of mortality and morbidity worldwide. Available effective therapies rely on imaging for decision making. Recent advances in the field now enable physicians to select appropriate patients for acute ischemic stroke treatment. Computed tomography continues to be the standard imaging modality in acute ischemic stroke assessment in most centers worldwide. Six recently published randomized trials, showing strong benefit from endovascular treatment in acute ischemic stroke, have mostly used computed tomography for patient selection. In this chapter, we will discuss non-contrast computed tomography, computed tomography angiography, and computed tomography perfusion imaging in patients with acute ischemic stroke. The different diagnostic, therapeutic, and prognostic implications, as well as the advantages and disadvantages of these modalities, will also be discussed.
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References
Menon BK, Puetz V, Kochar P, et al. ASPECTS and other neuroimaging scores in the triage and prediction of outcome in acute stroke patients. Neuroimaging Clin N Am. 2011;21:407–23.
Puetz V, Sylaja PN, Coutts SB, et al. Extent of hypoattenuation on CT angiography source images predicts functional outcome in patients with basilar artery occlusion. Stroke. 2008;39:2485–90.
Shobha N, Bal S, Boyko M, et al. Measurement of length of hyperdense MCA sign in acute ischemic stroke predicts disappearance after IV tPA. J Neuroimaging. 2014;24:7–10.
Bracard S, Ducrocq X, Mas JL, et al. Mechanical thrombectomy after intravenous alteplase versus alteplase alone after stroke (THRACE): a randomised controlled trial. Lancet Neurol. 2016;15:1138–47.
Goyal M, Menon BK, van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet. 2016;387:1723–31.
Holodinsky JK, Yu AY, Assis ZA, et al. History, evolution, and importance of emergency endovascular treatment of acute ischemic stroke. Curr Neurol Neurosci Rep. 2016;16:42.
Qazi E, Al-Ajlan FS, Najm M, et al. The role of vascular imaging in the initial assessment of patients with acute ischemic stroke. Curr Neurol Neurosci Rep. 2016;16:32.
Saver JL, Goyal M, van der Lugt A, et al. Time to treatment with endovascular thrombectomy and outcomes from ischemic stroke: a meta-analysis. JAMA. 2016;316:1279–88.
Menon BK, Demchuk AM. Computed tomography angiography in the assessment of patients with stroke/TIA. Neurohospitalist. 2011;1:187–99.
Eswaradass P, Appireddy R, Evans J, et al. Imaging in acute stroke. Expert Rev Cardiovasc Ther. 2016;14:963–75.
Demchuk AM, Menon BK, Goyal M. Comparing vessel imaging: noncontrast computed tomography/computed tomographic angiography should be the new minimum standard in acute disabling stroke. Stroke. 2016;47:273–81.
Menon BK, d’Esterre CD, Qazi EM, et al. Multiphase CT angiography: a new tool for the imaging triage of patients with acute ischemic stroke. Radiology. 2015;275:510–20.
Menon BK, Qazi E, Nambiar V, et al. Differential effect of baseline computed tomographic angiography collaterals on clinical outcome in patients enrolled in the interventional management of stroke III trial. Stroke. 2015;46:1239–44.
Bal S, Bhatia R, Menon BK, et al. Time dependence of reliability of noncontrast computed tomography in comparison to computed tomography angiography source image in acute ischemic stroke. Int J Stroke. 2015;10:55–60.
d’Esterre CD, Boesen ME, Ahn SH, et al. Time-dependent computed tomographic perfusion thresholds for patients with acute ischemic stroke. Stroke. 2015;46:3390–7.
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Al Sultan, A.S., Eesa, M., Menon, B.K. (2017). Principles and Practical Application of Brain CT in Acute Ischemic Stroke. In: Lee, SH. (eds) Stroke Revisited: Diagnosis and Treatment of Ischemic Stroke. Stroke Revisited. Springer, Singapore. https://doi.org/10.1007/978-981-10-1424-6_9
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DOI: https://doi.org/10.1007/978-981-10-1424-6_9
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