Article: CT perfusion in acute stroke

Stroke is a heterogeneous syndrome caused by multiple mechanisms, all of which result in disruption of normal cerebral blood flow and thereby cause cerebral dysfunction. Its early diagnosis is important as its treatment is dependent on the time elapsed since ictus. Delay in diagnosis and treatment translates into increase neuronal loss and thereby increased morbidity. CT scan, and in particular perfusion CT, has helped greatly in the early diagnosis of stroke. This article is an endeavor to explain the pathophysiology of cerebral ischemia and the role of CT perfusion in detecting it.

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References

1.

Rowley H . The four Ps of acute stroke imaging: parenchyma, pipes, perfusion, and penumbra. AJNR Am J Neuroradiol. 2001; 22(4):599-601. PMC: 7976007. View

2.

Latchaw R, Yonas H, Hunter G, Yuh W, Ueda T, Sorensen A . Guidelines and recommendations for perfusion imaging in cerebral ischemia: A scientific statement for healthcare professionals by the writing group on perfusion imaging, from the Council on Cardiovascular Radiology of the American Heart Association. Stroke. 2003; 34(4):1084-104. DOI: 10.1161/01.STR.0000064840.99271.9E. View

3.

Tomandl B, Klotz E, Handschu R, Stemper B, Reinhardt F, Huk W . Comprehensive imaging of ischemic stroke with multisection CT. Radiographics. 2003; 23(3):565-92. DOI: 10.1148/rg.233025036. View

4.

von Kummer R, Bourquain H, Bastianello S, Bozzao L, Manelfe C, Meier D . Early prediction of irreversible brain damage after ischemic stroke at CT. Radiology. 2001; 219(1):95-100. DOI: 10.1148/radiology.219.1.r01ap0695. View

5.

Mayer T, Hamann G, Baranczyk J, Rosengarten B, Klotz E, Wiesmann M . Dynamic CT perfusion imaging of acute stroke. AJNR Am J Neuroradiol. 2000; 21(8):1441-9. PMC: 7974057. View

6.

Beauchamp Jr N, Barker P, Wang P, vanZijl P . Imaging of acute cerebral ischemia. Radiology. 1999; 212(2):307-24. DOI: 10.1148/radiology.212.2.r99au16307. View

7.

Srinivasan A, Goyal M, Al Azri F, Lum C . State-of-the-art imaging of acute stroke. Radiographics. 2006; 26 Suppl 1:S75-95. DOI: 10.1148/rg.26si065501. View

8.

Crisostomo R, Garcia M, Tong D . Detection of diffusion-weighted MRI abnormalities in patients with transient ischemic attack: correlation with clinical characteristics. Stroke. 2003; 34(4):932-7. DOI: 10.1161/01.STR.0000061496.00669.5E. View

9.

Hjort N, Christensen S, Solling C, Ashkanian M, Wu O, Rohl L . Ischemic injury detected by diffusion imaging 11 minutes after stroke. Ann Neurol. 2005; 58(3):462-5. DOI: 10.1002/ana.20595. View

10.

Fisher M . Characterizing the target of acute stroke therapy. Stroke. 1997; 28(4):866-72. DOI: 10.1161/01.str.28.4.866. View

11.

Wintermark M, Reichhart M, Thiran J, Maeder P, Chalaron M, Schnyder P . Prognostic accuracy of cerebral blood flow measurement by perfusion computed tomography, at the time of emergency room admission, in acute stroke patients. Ann Neurol. 2002; 51(4):417-32. DOI: 10.1002/ana.10136. View

12.

Teksam M, Cakir B, Coskun M . CT perfusion imaging in the early diagnosis of acute stroke. Diagn Interv Radiol. 2005; 11(4):202-5. View

CT Perfusion in Acute Stroke