1. Stroke imaging
M3 radiology August 2014

2. Why used in ED
Add image
Head CT

3. What can head CT show?

4. Hemorrhagic infarct

5. Normal

6. Vasogenic
Cytotoxic

7. Large MCA Lev, Michael Radiology Oct 1999 p150-5
Look carefully with contrasty stroke windows to see subtle acute infarcts. This is a CTA. Works for CT nonconrast too. Still most acute infarcts not seen in first few hours. This does increase chance of seeing some acute infarcts by CT.
Lev, Michael Radiology Oct 1999 p150-5

8. Motorstrip
Where is the the bright gray matter not present? This is the acute infarct.

9. Motorstrip
Where is the the bright gray matter not present? This is the acute infarct.

10. Non contrast Dense vessel and CT angiogram clot

11. Top of ICA clot?
case

12. Clot on CTA

13. Case LP
Now
 One year prior

14. Basilar clot

15. Subacute or remote infarct

16. Take away White – Acute blood Black – Remote blood
Normal – Acute infarct
Black – Remote infarct
Take away

17. Acute infarct CT vs MRI

18. Insular ribbon

19. Basal ganglia

20. one Acute and one Chronic

21. Subacute and remote infarcts

22. CTA

23. IV tPA

24. Endovascular tPA or mechanical

25. Timing

26. MRI

27. Neck Vessels CTA, MRA, US, Catheter