Neurol. praxi. 2018;19(4):256-261 | DOI: 10.36290/neu.2018.043

Computed tomography in acute ischemic stroke

MUDr. Jan Vinklárek1, MUDr. Michal Haršány1,2, MUDr. Petra Cimflová2,3, doc. MUDr. Robert Mikulík, Ph.D.1,2, MUDr. Ondřej Volný, Ph.D.1,2
1 I. neurologická klinika, FN u sv. Anny a LF MU, Brno
2 Mezinárodní centrum klinického výzkumu, FN u sv. Anny, Brno
3 Klinika zobrazovacích metod, FN u sv. Anny a LF MU, Brno

Brain computed tomography (CT) is the most widely used and widespread imaging method in acute (vascular) neurology. Non-contrastbrain CT, CT angiography, and CT perfusion represent important imaging tools, complementary to clinical examination andpatients history, helping in diagnosis and decision-making on subsequent therapy. The main aim of this article is to summarizeCT imaging modalities, which are used in routine clinical practise.

Keywords: stroke, computed tomography

Received: June 19, 2018; Accepted: July 8, 2018; Published: September 1, 2018  Show citation

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Vinklárek J, Haršány M, Cimflová P, Mikulík R, Volný O. Computed tomography in acute ischemic stroke. Neurol. praxi. 2018;19(4):256-261. doi: 10.36290/neu.2018.043.
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    References

    1. Albers GW, Marks MP, Kemp S, Christensen S, Tsai JP, Ortega-Albers GW, Marks MP, Kemp S, Christensen S, Tsai JP, Ortega-Gutierrez S, McTaggart RA, Torbey MT, Kim-Tenser M, Leslie-Mazwi T, Sarraj A, Kasner SE, Ansari SA, Yeatts SD, Hamilton S, Mlynash M, Heit JJ, Zaharchuk G, Kim S, Carrozzella J, Palesch YY, Demchuk AM, Bammer R, Lavori PW, Broderick JP, Lansberg MG. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. N. Engl. J. Med. 2018; 378: 708-718. Go to original source... Go to PubMed...
    2. 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 Lond. Engl. 2000; 355: 1670-1674. Go to original source...
    3. Berkhemer OA, Fransen PS, Beumer D, van den Berg LA, Lingsma HF, Yoo AJ, Schonewille WJ, Vos JA, Nederkoorn PJ, Wermer MJ, van Walderveen MA, Staals J, Hofmeijer J, van Oostayen JA, Lycklama ? Nijeholt GJ, Boiten J, Brouwer PA, Emmer BJ, de Bruijn SF, van Dijk LC, Kappelle LJ, Lo RH, van Dijk EJ, de Vries J, de Kort PL, van Rooij WJ, van den Berg JS, van Hasselt BA, Aerden LA, Dallinga RJ, Visser MC, Bot JC, Vroomen PC, Eshghi O, Schreuder TH, Heijboer RJ, Keizer K, Tielbeek AV, den Hertog HM, Gerrits DG, van den Berg-Vos RM, Karas GB, Steyerberg EW, Flach HZ, Marquering HA, Sprengers ME, Jenniskens SF, Beenen LF, van den Berg R, Koudstaal PJ, van Zwam WH, Roos YB, van der Lugt A, van Oostenbrugge RJ, Majoie CB, Dippel DW. A randomized trial of intraarterial treatment for acute ischemic stroke. N. Engl. J. Med. 2015; 372: 11-20. Go to original source...
    4. Campbell BC, Mitchell PJ, Kleinig TJ, Dewey HM, Churilov L, Yassi N, Yan B, Dowling RJ, Parsons MW, Oxley TJ, Wu TY, Brooks M, Simpson MA, Miteff F, Levi CR, Krause M, Harrington TJ, Faulder KC, Steinfort BS, Priglinger M, Ang T, Scroop R, Barber PA, McGuinness B, Wijeratne T, Phan TG, Chong W, Chandra RV, Bladin CF, Badve M, Rice H, de Villiers L, Ma H, Desmond PM, Donnan GA, Davis SM. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N. Engl. J. Med. 2015; 372: 1009-1018. Go to original source... Go to PubMed...
    5. 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: 273-281. Go to original source... Go to PubMed...
    6. Derex L, Hermier M, Adeleine P, Pialat JB, Wiart M, Berthez?ne Y, Philippeau F, Honnorat J, Froment JC, Trouillas P, Nighoghossian N. Clinical and imaging predictors of intracerebral haemorrhage in stroke patients treated with intravenous tissue plasminogen activator. J. Neurol. Neurosurg. Psychiatry 2005; 76: 70-75. Go to original source...
    7. Goyal M, Demchuk AM, Menon BK, Eesa M, Rempel JL, Thornton J, Roy D, Jovin TG, Willinsky RA, Sapkota BL, Dowlatshahi D, Frei DF, Kamal NR, Montanera WJ, Poppe AY, Ryckborst KJ, Silver FL, Shuaib A, Tampieri D, Williams D, Bang OY, Baxter BW, Burns PA, Choe H, Heo JH, Holmstedt CA, Jankowitz B, Kelly M, Linares G, Mandzia JL, Shankar J, Sohn SI, Swartz RH, Barber PA, Coutts SB, Smith EE, Morrish WF, Weill A, Subramaniam S, Mitha AP, Wong JH, Lowerison MW, Sajobi TT, Hill MD. Randomized assessment of rapid endovascular treatment of ischemic stroke. N. Engl. J. Med. 2015; 372: 1019-1030. Go to original source... Go to PubMed...
    8. Goyal M, Menon BK, van Zwam WM, Dippel DW, Mitchell PJ, Demchuk AM, Dávalos A, Majoie CB, van der Lugt A, de Miquel MA, Donnan GA, Roos YB, Bonafe A, Jahan R, Diener HC, van den Berg LA, Levy EI, Berkhemer OA, Pereira V, Rempel J, Millán M, Davis SM, Roy D, Thornton J, Román LS, Ribó M, Beumer D, Stouch B, Brown S, Campbell BC, van Oostenbrugge RJ, Saver JL, Hill MD, Jovin TG. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet Lond. Engl. 2016; 387: 1723-1731. Go to original source...
    9. Gupta AC, Schaefer PW, Chaudhry ZA, Leslie-Mazwi TM, Chandra R V, González RG, Hirsch JA, Yoo AJ. Interobserver reliability of baseline noncontrast CT Alberta Stroke Program Early CT Score for intra-arterial stroke treatment selection. AJNR Am J Neuroradiol 2012; 33: 1046-1049. Go to original source...
    10. Herweh C, Ringleb PA, Rauch G, Gerry S, Behrens L, Möhlenbruch M, Gottorf R, Richter D, Schieber S, Nagel S. Performance of e-ASPECTS software in comparison to that of stroke physicians on assessing CT scans of acute ischemic stroke patients. Int J Stroke 2016; 11: 438-445. Go to original source... Go to PubMed...
    11. Jovin TG, Chamorro A, Cobo E, de Miquel MA, Molina CA, Rovira A, San Román L, Serena J, Abilleira S, Ribó M, Millán M, Urra X, Cardona P, López-Cancio E, Tomasello A, Casta?o C, Blasco J, Aja L, Dorado L, Quesada H, Rubiera M, Hernandez-Pérez M, Goyal M, Demchuk AM, von Kummer R, Gallofré M, Dávalos A. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N. Engl. J. Med. 2015; 372: 2296-2306. Go to original source...
    12. Král J, Jonszta T, Marcián V, Tomášková H, Bar M. Shoda v hodnocení čerstvých ischemických změn pomocí ASPECT skóre mezi neurologem a intervenčním neuroradiologem u pacientu? s akutní mozkovou ischemií. Cesk Slov Neurol N 2018; 81(3): 304-307. Go to original source...
    13. Kucinski T. Unenhanced CT and acute stroke physiology. Neuroimaging Clin. N. Am. 2005; 15: 397-407, xi-xii. Go to original source...
    14. von Kummer R, Allen KL, Holle R, Bozzao L, Bastianello, S, Manelfe C, Bluhmki E, Ringleb P, Meier, DH, Hacke W. cute stroke: usefulness of early CT findings before thrombolytic therapy. Radiology 1997; 205: 327-333. Go to original source... Go to PubMed...
    15. Menon BK, Demchuk AM. Computed tomography angiography in the assessment of patients with stroke/TIA. The Neurohospitalist 2011; 1: 187-199. Go to original source... Go to PubMed...
    16. Menon BK, Campbell BCV, Levi C, Goyal M. Role of imaging in current acute ischemic stroke workflow for endovascular therapy. Stroke 2015A; 46: 1453-1461. Go to original source... Go to PubMed...
    17. Menon BK, d'Esterre CD, Qazi EM, Almekhlafi M, Hahn L, Demchuk AM, Goyal M. Multiphase CT angiography: a new tool for the imaging triage of patients with acute ischemic stroke. Radiology 2015B; 275: 510-520. Go to original source... Go to PubMed...
    18. Mokin M, Levy EI, Saver JL, Siddiqui AH, Goyal M, Bonafé A, Cognard C, Jahan R, Albers GW, SWIFT PRIME Investigators. Predictive Value of RAPID Assessed Perfusion Thresholds on Final Infarct Volume in SWIFT PRIME (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment). Stroke 2017; 48: 932-938. Go to original source... Go to PubMed...
    19. Nagel S, Sinha D, Day D, Reith W, Chapot R, Papanagiotou P, Warburton EA, Guyler P, Tysoe S, Fassbender K, Walter S, Essig M, Heidenrich J, Konstas AA, Harrison M, Papadakis M, Greveson E, Joly O, Gerry S, Maguire H, Roffe C, Hampton-Till J, Buchan AM, Grunwald IQ. e-ASPECTS software is non-inferior to neuroradiologists in applying the ASPECT score to computed tomography scans of acute ischemic stroke patients. Int J Stroke 2017; 12: 615-622. Go to original source... Go to PubMed...
    20. Naylor J, Churilov L, Rane N, Chen Z, Campbell BCV, Yan B. Reliability and utility of the alberta stroke program early computed tomography score in hyperacute stroke. J Stroke Cerebrovasc Dis 2017; 26: 2547-2552. Go to original source...
    21. Nogueira RG, Jadhav AP, Haussen DC, Bonafe A, Budzik RF, Bhuva P, Yavagal DR, Ribo M, Cognard C, Hanel RA, Sila CA, Hassan AE, Millan M, Levy EI, Mitchell P, Chen M, English JD, Shah QA, Silver FL, Pereira VM, Mehta BP, Baxter BW, Abraham MG, Cardona P, Veznedaroglu E, Hellinger FR, Feng L, Kirmani JF, Lopes DK, Jankowitz BT, Frankel MR, Costalat V, Vora NA, Yoo AJ, Malik AM, Furlan AJ, Rubiera M, Aghaebrahim A, Olivot JM, Tekle WG, Shields R, Graves T, Lewis RJ, Smith WS, Liebeskind DS, Saver JL, Jovin TG. Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N. Engl. J. Med. 2018; 378: 11-21. Go to original source... Go to PubMed...
    22. Pallesen LP, Gerber J, Dzialowski I, van der Hoeven EJ, Michel P, Pfefferkorn T, Ozdoba C, Kappelle LJ, Wiedemann B, Khomenko A, Algra A, Hill MD, von Kummer R, Demchuk AM, Schonewille WJ, Puetz V. Diagnostic and prognostic impact of pc-ASPECTS applied to perfusion CT in the basilar artery international cooperation study. J Neuroimaging 2015; 25: 384-389. Go to original source... Go to PubMed...
    23. Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, Biller J, Brown M, Demaerschalk BM, Hoh B, Jauch EC, Kidwell CS, Leslie-Mazwi TM, Ovbiagele B, Scott PA, Sheth KN, Southerland AM, Summers DV, Tirschwell DL. 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(3): e46-e110. Go to original source... Go to PubMed...
    24. Puetz V, Sylaja PN, Coutts SB, Hill MD, Dzialowski I, Mueller P, Becker U, Urban G, O'Reilly C, Barber PA, Sharma P, Goyal M, Gahn G, von Kummer R, Demchuk AM. Extent of hypoattenuation on CT angiography source images predicts functional outcome in patients with basilar artery occlusion. Stroke 2008; 39(9): 2485-2490. Go to original source... Go to PubMed...
    25. Puig J, Pedraza S, Demchuk A, Daunis-I-Estadella J, Termes H, Blasco G, Soria G, Boada I, Remollo S, Ba?os J, Serena J, Castellanos M. Quantification of thrombus hounsfield units on noncontrast CT predicts stroke subtype and early recanalization after intravenous recombinant tissue plasminogen activator. AJNR Am. J. Neuroradiol. 2012; 33: 90-96. Go to original source... Go to PubMed...
    26. Sandercock P, Lindley R, Wardlaw J, Dennis M, Lewis S, Venables G, Kobayashi A, Czlonkowska A, Berge E, Slot KB, Murray V, Peeters A, Hankey G, Matz K, Brainin M, Ricci S, Celani MG, Righetti E, Cantisani T, Gubitz G, Phillips S, Arauz A, Prasad K, Correia M, Lyrer P. The third international stroke trial (IST-3) of thrombolysis for acute ischaemic stroke. Trials 2008; 9: 37. Go to original source... Go to PubMed...
    27. Saver JL, Goyal M, Bonafe A, Diener HC, Levy EI, Pereira VM, Albers GW, Cognard C, Cohen DJ, Hacke W, Jansen O, Jovin TG, Mattle HP, Nogueira RG, Siddiqui AH, Yavagal DR, Baxter BW, Devlin TG, Lopes DK, Reddy VK, du Mesnil de Rochemont R, Singer OC, Jahan R. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. N. Engl. J. Med. 1995; 372: 2285-2295. Go to original source...
    28. National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue Plasminogen Activator for Acute Ischemic Stroke. N. Engl. J. Med. 2015; 333: 1581-1588. Go to original source...

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