CT in Basic Emergency Stroke Imaging

Goal of CT :
1. Rule out Hemorrhage and Stroke mimics
2. Detect infarcted tissue
3. Quantify infarcted tissue

Advantages of CT over MRI in Emergency setting
1. Wide availability
2. Less Prescreening - Only for contrast allergy and Kidney function
3. Faster scan time
4. Metallic equipments can safely accompany the patients which facilitates easier monitoring of acute stroke patients







  Signs of Stroke on CT

1. A.Hypodensity 
on CT is a sign of irreversible ischaemic damage.



2. Obscuration of the Lentiform Nucleus


3. Insular Ribbon sign


Early Subtle hypodensity seen in the Insular cortex. It indicates MCA infarct.

4. Dense Artery Sign - Dense MCA sign


Density with an artery indicates thrombus or emboli.

5. Loss of sulcal effacement with loss of grey-white differentiation.





NECT shows Dense MCA sign - Arrowhead , Insular ribbon sign - White arrow , Loss of sulcal effacement - Black arrow



References:
a. Radiology clinics of North America
b. Radiopgraphics.rsna.com
c. Radiologyassistant.nl

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