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Stroke Research and Treatment
Volume 2011, Article ID 726573, 10 pages
http://dx.doi.org/10.4061/2011/726573
Clinical Study

Comprehensive CT Evaluation in Acute Ischemic Stroke: Impact on Diagnosis and Treatment Decisions

1Department of Neuroradiology, Skåne University Hospital, Lund University, Getingevägen 4, 221 85 Lund, Sweden
2Department of Neurology and Wallenberg Neuroscience Center, Skåne University Hospital, Lund University, 221 85 Lund, Sweden

Received 26 November 2010; Revised 12 January 2011; Accepted 19 January 2011

Academic Editor: Chelsea S. Kidwell

Copyright © 2011 Askell Löve et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. With modern CT imaging a comprehensive overview of cerebral macro- and microcirculation can be obtained within minutes in acute ischemic stroke. This opens for patient stratification and individualized treatment. Methods. Four patients with acute ischemic stroke of different aetiologies and/or treatments were chosen for illustration of the comprehensive CT protocol and its value in subsequent treatment decisions. The patients were clinically evaluated according to the NIHSS-scale, examined with the comprehensive CT protocol including both CT angiography and CT perfusion, and followed up by MRI. Results. The comprehensive CT examination protocol increased the examination time but did not delay treatment initiation. In some cases CT angiography revealed the cause of stroke while CT perfusion located and graded the perfusion defect with reasonable accuracy, confirmed by follow-up MR-diffusion. In the presented cases findings of the comprehensive CT examination influenced the treatment strategy. Conclusions. The comprehensive CT examination is a fast and safe method allowing accurate diagnosis and making way for individualized treatment in acute ischemic stroke.