Non-contrast CT imaging is the current diagnostic standard for stroke imaging  mainly due to its close to 100% high sensitivity for intracerebral hemorrhage (ICH), which is the most important differential diagnosis for ischemic stroke . A standard CT protocol includes axial CT scanning with a slice thickness of 3–5 mm for the posterior fossa and 8–10 mm for suprasellar structures. Indeed the differentiation of ischemic stroke and ICH by clinical means alone is impossible. Although early deterioration of vigilance, vomiting in anterior circulation as opposed to posterior circulation syndrome, coumadine therapy, or a hypertensive crisis may hint towards ICH, these symptoms can also be seen in ischemic stroke. Mainly in the early 1990s and based on the CT images collected in thrombolysis trials, an effort was made to also define early signs of ischemic infarction on CT scans.
KeywordsIschemic Stroke Ischemic Infarction NIHSS Score Aspect Score Stroke Image
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