Imaging of Cerebrovascular Disease

Question 1

Is the right or left vertebral artery usually dominant?

Answer 1

Left

Question 2

4 P’s of acute stroke imaging

Answer 2

Parenchyma
Pipes
Perfusion
Penumbra

Question 3

What modalities is normally used for acute stroke?

Answer 3

CT (fast, accessible)

MRI as well (but less available, takes longer)

Question 4

What is a hyperdense sign?

Answer 4

When an artery looks white on CT

Predicts higher thrombus burden and potential for poorer outcome

Question 5

Dot sign vs Spot sign

Answer 5

Dot: Corresponds to thrombus in distal MCA branches. Same as hyperdense sign just further along the vessel
Spot: points to active bleeding in a hemorrhagic stroke

Question 6

Conjugate eye deviation

Answer 6

20% of those with cerebral hemispheric stroke
Lateralizes to ipsilateral hemisphere
Improves sensitivity of assessment on CT

Question 7

CT angiography advantages

Answer 7

Data obtained quickly and safely
More complete anatomical information
Can alter management significantly