CT angiography in acute ischemic stroke: preliminary results.
OBJECTIVE
We sought to evaluate the ability of CT angiography (CTA) to determine vessel occlusion before acute stroke treatment and to predict its impact on patient outcome.


METHODS
Consecutive patients with acute focal neurological deficits received immediate brain CTA. Occlusion on CTA was correlated with other neuroimaging studies and clinical outcome.


RESULTS
Diagnostic CTA was obtained in 54 patients: catheter angiography (digital subtraction angiography) confirmed the CTA findings in 12 of 14 patients (86%). CTA results were consistent with at least 1 other neuroimaging study in 40 of 50 patients (80%). Patients with occlusion on CTA had significantly worse discharge National Institutes of Health Stroke Scale (NIHSS) score (mean 14.3 versus 4.5, P=0.0023). In multivariate analysis, both CTA-determined presence of occlusion and admission NIHSS score were independent predictors of clinical outcome.


CONCLUSIONS
In our study there was good agreement between acute CTA interpretation and subsequent imaging studies. CTA evidence of occlusion correlated strongly and independently with poor clinical outcome. CTA provides relevant data regarding vessel patency in acute stroke, which may be of value in selecting patients for aggressive treatment.
Verro
Piero
P
University of California at Davis School of Medicine, Sacramento 95817, USA. piero.verro@ucdmc.ucdavis.edu
Tanenbaum
Lawrence N
LN
Borden
Neil M
NM
Sen
Souvik
S
Eshkar
Noam
N
D000208:Acute Disease; D015901:Angiography, Digital Subtraction / Q000379:methods; D002545:Brain Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography / Q000379:methods*; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging; D018810:Magnetic Resonance Angiography; D020521:Stroke / Q000175:diagnosis / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome