title: Detectability of cerebral hemisphere ischaemic infarcts by CT within 6 h of stroke.
abstract: To determine how early and how reliably ischaemic brain infarcts can be detected on CT within 6 h of the onset of cerebral hemisphere strokes, 44 such studies were interpreted by an experienced neuroradiologist blinded to clinical signs, but aware that the cohort was a stroke population. He was asked to detect and localise an area of parenchymal low density and/or focal brain swelling. A follow-up study showing the definite infarct served as a reference in each case. In 38 patients areas of slightly low density were seen, and in 36 follow-up CT confirmed infarcts in the locations indicated. In 2 patients the reading was false positive. In 6 patients no low density focus could be detected. In these 8 patients examined by CT within 180 min of the stroke, no low density could be identified, even in retrospect with the knowledge of the findings on follow-up. Thus, 42 readings (95%) were true positive or true negative; 2 were false positive; and none was a false negative. CT within 6 h of the onset of symptoms has a mean sensitivity of 82% (36/44) for ischaemic cerebral hemisphere infarcts. By contrast, its sensitivity to ischaemic parenchymal low density is low during the initial 2 h. The early development of hemispheric infarcts can be detected reliably if the radiologist is familiar with the signs.
authors.affiliation: Department of Neuroradiology, University of Heidelberg, Germany.
authors.forename: R
authors.initials: R
authors.lastname: von Kummer
authors.forename: P N
authors.initials: PN
authors.lastname: Nolte
authors.forename: H
authors.initials: H
authors.lastname: Schnittger
authors.forename: A
authors.initials: A
authors.lastname: Thron
authors.forename: E B
authors.initials: EB
authors.lastname: Ringelstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001929:Brain Edema / Q000000981:diagnostic imaging; D002544:Cerebral Infarction / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D004292:Dominance, Cerebral / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed