title: Contrast-Enhanced Computed Tomography as a Necessary Scan in Acute Stroke: A Case Series.
abstract: BACKGROUND
  We present a number of exemplary cases where the diagnostic value of the contrast-enhanced computed tomography (CT) after CT angiography in our acute stroke imaging protocol was of fundamental clinical significance.
  
  
  METHODS
  We retrospectively reviewed 7 cases presented to the emergency room, between 2012 and 2014, suspected of acute stroke, with findings diagnosed by the contrast-enhanced CT.
  
  
  RESULTS
  Seven exemplary cases: acute midbrain infarct versus posterior-fossa artefact differentiation in contrast-enhanced CT; differentiation between an M1 occlusion and an internal carotid artery dissection in contrast-enhanced CT; diagnosis of veno-occlusive disease rather than arterial occlusion; bleeding arterial aneurysm revealed by contrast-enhanced CT; previously unsuspected sinus vein thrombosis; sinus vein thrombosis suspected in CT angiography, ruled out by contrast-enhanced CT; and space occupying lesion clearly diagnosed by contrast-enhanced CT.
  
  
  CONCLUSIONS
  Adding contrast-enhanced CT as a part of the acute stroke imaging protocol presents additional diagnoses and avoids pitfalls. Therefore, we consider the contrast-enhanced CT to be essential to the acute stroke setting imaging protocol.
authors.affiliation: Radiology Department, Assaf Harofeh Medical Center, Zerifin, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel.
authors.forename: Sigal
authors.initials: S
authors.lastname: Tal
authors.affiliation: Neurology Department, Assaf Harofeh Medical Center, Zerifin, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel.
authors.forename: Lea
authors.initials: L
authors.lastname: Pollak
authors.affiliation: Radiology Department, Assaf Harofeh Medical Center, Zerifin, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel. Electronic address: nadavber@gmail.com.
authors.forename: Nadav
authors.initials: N
authors.lastname: Berkovitz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography; D003287:Contrast Media / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media
keywords: Acute stroke; acute stroke imaging; contrast-enhanced CT; stroke mimics