How to Distinguish between Venous and Arterial Strokes and Why?
Cerebral venous infarct is considered to be rare (0-5% of all strokes). In some cases venous infarcts with no specific signs on conventional CT or MR study are not diagnosed due to incomplete examination. A venous infarct more often (63%) than an arterial (15%) infarct is accompanied by hemorrhage (primary or secondary in the early period) and a high risk of hemorrhage should be a contraindication to intravenous thrombolysis. Consequently, the definition of the kind of a stroke should lead to different therapeutic tactics. Using MR and CT angiographic and perfusion techniques in the urgent examination of patients with an infarct, considering time necessary for the "time window", can lead to exact diagnosis and fewer complications.
Research Institute of Cardiovascular Disorders; Kemerovo, Russia - semenov@cardio.kem.ru, sts63@list.ru.
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Moldavskaya
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Shatokhina
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Barbarash