title: CT imaging selection in acute stroke.
abstract: Acute stroke has become an increasingly treatable cause of acute neurological deficits. Indeed, over the last two decades, the introduction of first thrombolysis, and now thrombectomy has improved patient outcomes and extended the therapeutic window. Computed tomography has been established as the most simple and readily available technique for the diagnosis and management of patients with acute stroke. Indeed, CT allows easy confirmation or exclusion of acute hemorrhage on the one hand, and on the other hand the early signs are quite reliable in the detection of ischemia. In the early phase the clot can be seen as well as exchanges related to early changes in water concentration in ischemia and the surrounding penumbra. Additional techniques such as angio-CT show the location of the clot and perfusion techniques reveal local hemodynamics as well as potential tissue viability. Newer techniques such as double energy CT and late phase CT should provide information on collateral flow as well as on the presence of early hemorrhagic transformation. All these techniques should thus make available new information on tissue viability,that is indispensable in the choice of revascularization technique. Thus CT techniques allow a quick and reliable triage as well as a finer characterization of the ischemic process. The use of all these CT techniques in an optimal way should help improve patient triage and selection of the most adequate treatment with further improvements in clinical outcomes as a result.
authors.affiliation: Division of Diagnostic and Interventional Neuroradiology, Geneva University Hospitals and Medical School, 1211, Geneva, Switzerland.
authors.forename: Laurie
authors.initials: L
authors.lastname: Bouchez
authors.affiliation: Division of Diagnostic and Interventional Neuroradiology, Geneva University Hospitals and Medical School, 1211, Geneva, Switzerland.
authors.forename: Roman
authors.initials: R
authors.lastname: Sztajzel
authors.affiliation: Division of Diagnostic and Interventional Neuroradiology, Geneva University Hospitals and Medical School, 1211, Geneva, Switzerland.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Vargas
authors.affiliation: Division of Diagnostic and Interventional Neuroradiology, Geneva University Hospitals and Medical School, 1211, Geneva, Switzerland.
authors.forename: Paolo
authors.initials: P
authors.lastname: Machi
authors.affiliation: Division of Diagnostic and Interventional Neuroradiology, Geneva University Hospitals and Medical School, 1211, Geneva, Switzerland.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Kulcsar
authors.affiliation: Division of Diagnostic and Interventional Neuroradiology, Geneva University Hospitals and Medical School, 1211, Geneva, Switzerland.
authors.forename: Pierre-Alexandre
authors.initials: PA
authors.lastname: Poletti
authors.affiliation: Division of Diagnostic and Interventional Neuroradiology, Geneva University Hospitals and Medical School, 1211, Geneva, Switzerland.
authors.forename: Vitor Mendes
authors.initials: VM
authors.lastname: Pereira
authors.affiliation: Division of Diagnostic and Interventional Neuroradiology, Geneva University Hospitals and Medical School, 1211, Geneva, Switzerland. Electronic address: karl-olof.lovblad@hcuge.ch.
authors.forename: Karl-Olof
authors.initials: KO
authors.lastname: Lövblad
mesh_terms: D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D002560:Cerebrovascular Circulation; D059907:Functional Neuroimaging; D006801:Humans; D020127:Recovery of Function; D020521:Stroke / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D017131:Thrombectomy; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Computed tomography; Imaging; Stroke; Thrombectomy