26. Neuroradiology. Imaging of acute intracranial vascular diseases. Stroke.

From greek.doctor
  • Ischaemic stroke
    • Gold standard: Multimodal CT evaluation
      • Non-contrast CT
      • CT angiography
      • CT perfusion
    • Diffusion weighted MRi
      • Shows ischaemia within minutes
      • Ischaemia causes decreased tissue water diffusion
    • Phases
      • Acute phase
        • CT cannot reliably detect ischaemia this early (< 24 hours)
        • However, CT may detect the embolus itself (hyperdense artery, often middle cerebral a.)
      • Subacute phase (after 12-24  hours)
        • Ischaemic tissue is hypodense
        • Ischaemic tissue swells -> mass effect
      • Chronic phase (after days)
        • Ischaemic tissue becomes less hypodense (but is still hypodense)
  • Haemorrhagic stroke
    • Gold-standard: Multimodal CT evaluation
      • Non-contrast CT
      • CT angiography
      • CT perfusion
    • Phases
      • Acute phase (< 24 hours)
        • Hyperdense (blood)
      • Subacute phase (after 24 hours)
        • Isodense with brain
      • Chronic phase (after days)
        • Hypodense
  • Brain aneurysm
    • CT or MR angiography