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Vol 8, No 2 (2006)
Prace kazuistyczne
Published online: 2006-08-04
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Complex diagnostic imaging of acute ischemic stroke - case study

Marcin Hartel, Maria Dziubińska-Basiak, Marek Konopka, Marcin Basiak, Basim Salam, Marek Sąsiadek
Udar Mózgu. Problemy Interdyscyplinarne 2006;8(2):81-86.

open access

Vol 8, No 2 (2006)
Prace kazuistyczne
Published online: 2006-08-04

Abstract


Introduction. Ischemic stroke is the third most frequent cause of death in developed countries. Nowadays, when thrombolytic treatment is available, a proper qualification of patients is very important and the best candidates to thrombolysis are the patients in whom area of penumbra is larger than area of stroke.
Case report. We present a case of patient hospitalized due to symptoms of acute ischemic stroke in area of left middle cerebral artery (MCA) territory. The patient underwent brain computed tomography (CT) followed by perfusion CT (CTP), magnetic resonance diffusion (DWI) and magnetic resonance angiography (MRA). CT revealed early signs of ischemic stroke; CTP demonstrated area of penumbra, which predominated over area of infarction; MRA revealed loss of flow within left internal carotid artery (ICA) and left MCA. Based on performed examinations intraarterial thrombolytic treatment was indicated, instead of systemic thrombolysis.
Conclusions. Diagnostic protocol consisting of basic (CT), functional (e.g. CTP) and vascular examinations (CT angiography or MRA) may show extent of ischemic lesion (penumbra/infarction) and vascular pathology, that is helpful in qualification to thrombolytic treatment, particularly when undertaking decision, which method of thrombolysis should be used.

Abstract


Introduction. Ischemic stroke is the third most frequent cause of death in developed countries. Nowadays, when thrombolytic treatment is available, a proper qualification of patients is very important and the best candidates to thrombolysis are the patients in whom area of penumbra is larger than area of stroke.
Case report. We present a case of patient hospitalized due to symptoms of acute ischemic stroke in area of left middle cerebral artery (MCA) territory. The patient underwent brain computed tomography (CT) followed by perfusion CT (CTP), magnetic resonance diffusion (DWI) and magnetic resonance angiography (MRA). CT revealed early signs of ischemic stroke; CTP demonstrated area of penumbra, which predominated over area of infarction; MRA revealed loss of flow within left internal carotid artery (ICA) and left MCA. Based on performed examinations intraarterial thrombolytic treatment was indicated, instead of systemic thrombolysis.
Conclusions. Diagnostic protocol consisting of basic (CT), functional (e.g. CTP) and vascular examinations (CT angiography or MRA) may show extent of ischemic lesion (penumbra/infarction) and vascular pathology, that is helpful in qualification to thrombolytic treatment, particularly when undertaking decision, which method of thrombolysis should be used.
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Keywords

ischemic stroke; CT; MR; CT perfusion; diffusion-weighted imaging

About this article
Title

Complex diagnostic imaging of acute ischemic stroke - case study

Journal

Interdisciplinary Problems of Stroke

Issue

Vol 8, No 2 (2006)

Pages

81-86

Published online

2006-08-04

Bibliographic record

Udar Mózgu. Problemy Interdyscyplinarne 2006;8(2):81-86.

Keywords

ischemic stroke
CT
MR
CT perfusion
diffusion-weighted imaging

Authors

Marcin Hartel
Maria Dziubińska-Basiak
Marek Konopka
Marcin Basiak
Basim Salam
Marek Sąsiadek

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