Ch 1 - Stroke: Diagnostics Flashcards
How does an infarct appear on CT?
Black
Focally decreases density (hypodense) = darker than normal
When does an infarct appear on CT?
If mass effect then immediate
~24hr d/t edema
Best in 3-4 days
How does an infarct appear on MRI?
White
Edema/fluid= high signal density
When does an infarct appear on MRI?
Immediately as bright white on T2=edema= water
How does a hemorrhage appear on CT?
White
Hyperdense (radio-opaque)
When does a hemorrhage appear on CT?
Seen immediately
How does a hemorrhage appear on MRI?
Black (on T1 or T2)
Low density signal
What is the major role of using head CT in CVA?
Evaluating for presence of blood especially when thrombolysis is being considered
What is the study of choice for intracranial hemorrhage (ICH)?
CT head without contrast
When can a subarachnoid hemorrhage (SAH) be detected on CT?
Acute stage in 1st 4-5 days when blood is denser (white) than CSF
What is MRI better at detecting over CT in CVA?
Acute ischemic infarcts
Posterior cranial fossa infarcts
What is the most sensitive and specific imaging technique for acute infarctions?
Diffusion-weighted imaging (DWI) MRI
What is carotid US used for?
Screening for carotid stenosis
What is transcranial doppler US used for?
Velocity and direction of flow in Circle of Willis
Detects vasospasm and intracranial collateral pathways
What is angiography useful for diagnosing?
Aneurysms Vascular malformations Arterial dissections Narrow/occluded vessels Angiitis