This module will introduce you to the initial presentation of acute stroke and clinical features to help recognize signs and symptoms of stroke. Localization of symptoms and clues provided in the clinical exam will be discussed. Associated clinical syndromes of stroke will be discussed.
Pathophysiology of vascular occlusion could depend on a number of underlying patient factors and conditions. Many etiological causes exists that either causes in vessel thrombosis, for example coagulopathy, while others may include an embolic source such as in atrial fibrillation or intrinsic to cardiac defects. Potential etiological causes of stroke will be explored in this module in an example based format.
Overview of basic imaging armementerium and strategoies for detection of vascular occlusion and tissue involved in acute ischemic stroke. Different imaging modalities, such as CT, CTA, mCTA, CTP, and MRI, along with their advantages and drawbacks will be discussed.
Findings on non-contrast CT head and early parenchymal changes associated with acute vascular occlusion will be discussed highlighting important imaging signs to look for and note ignore. Multiple case based examples will take you through how to better identify these signs to detect early ischemic stroke.
Alberta Stroke Program Early CT score (ASPECTS), a 10-point quantitative score used to assess early ischemic changes on non-contrast CT head will be discussed.
ASPECTS score is a simple and reliable tool for detection of early ischemic changes on initial non-contrast CT scans of the brain.
The concepts behind multiphase CTA and assistive roles of contrast hold up or delay on the additional phases in identification of the site of vascular occlusion will be discussed. Assessment of collateral circulation and scoring of collateral vessels will be introduced.
General approach to the procedure and selective identification of patients that would benefit from mechanical thrombectomy will be discussed. Recent advances in technique and equipment used in EVT will be talked about highlighting the importance of their role in the clinical trials investigating the efficacy of the intervention.
Tips and tricks on how to improve imaging of acute stroke and detection of early ischemic changes. Role of MIP reconstruction, multiplanar reformats, contrast timing, and other technical aspects of performing and reconstructing the images will be dicussed.