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Extended use of cranial CT in the evaluation of patients with stroke and transient ischaemic attacks

J M Stevens1, C J Barber, R Kerslake

  • 1Department of Diagnostic Radiology, St Mary's Hospital, London, UK.

Neuroradiology
|January 1, 1991
PubMed

Insights

Computed tomography (CT) findings of ischemic brain damage may help assess carotid artery stenosis relevance in some patients. CT results influenced treatment decisions, particularly carotid endarterectomy, in a subset of cases.

Area of Science:

  • Neurology
  • Radiology
  • Vascular Surgery

Background:

  • Clinical features alone may not fully indicate the significance of carotid artery stenosis.
  • Computed tomography (CT) offers detailed visualization of ischemic brain damage patterns.

Purpose of the Study:

  • To evaluate if CT-detected ischemic brain damage patterns are more valuable than clinical presentation in assessing the relevance of carotid artery stenosis.
  • To determine if CT findings influence patient management decisions.

Main Methods:

  • 312 patients with known clinical features and management underwent blinded assessment of five angiographic and six CT abnormalities.
  • Data from independent charting of abnormalities were combined for statistical analysis.

Main Results:

  • Statistically significant associations were found between specific CT lesions and angiographic abnormalities in 18% of patients.
  • Clinical feature distribution in this subset did not significantly differ from the overall patient population.

Conclusions:

  • The hypothesis that CT findings can be more valuable than clinical features in assessing carotid artery stenosis relevance was upheld in a subset of patients.
  • CT findings appeared to modulate management decisions, leading to increased carotid endarterectomy in the identified subset.

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