Recent ischemic brain infarcts at computed tomography: appearances pre- and postcontrast infusion

Area of Science:

• Neuroradiology
• Neurology
• Medical Imaging

Background:

• Recent ischemic brain infarcts are a significant cause of neurological deficits.
• Accurate assessment of infarct age is crucial for timely and appropriate treatment decisions.
• Cranial computed tomography (CCT) is a primary imaging modality for evaluating acute brain conditions.

Purpose of the Study:

• To evaluate the reliability of noninfused CCT in determining the age of recent ischemic brain infarcts.
• To identify imaging characteristics of infarcts that may mimic other intracranial pathologies, such as tumors.

Main Methods:

• Analysis of 37 cranial computed tomography (CCT) scans from patients with confirmed recent ischemic brain infarcts.
• Visual and numerical assessment of CCT scans, categorized by infarct age.
• Evaluation of infarct appearance with and without contrast infusion.

Main Results:

• Ischemic brain infarcts typically present as homogeneous low-density abnormalities on noninfused CCT.
• No significant differences in CCT scan characteristics were observed across different infarct age groups.
• Eight infarcts exhibited mass effect, and 4 of 20 contrast-infused scans showed significant "blush" (density augmentation).

Conclusions:

• Noninfused CCT appearance alone is insufficient to determine the age of recent ischemic brain infarcts.
• Ischemic infarcts can present with mass effect and contrast enhancement, potentially mimicking brain tumors on CCT.