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Related Experiment Videos

Computed tomographic patterns of proven embolic brain infarctions.

E B Ringelstein1, S Koschorke, A Holling

  • 1Department of Neurology, University Hospital, Aachen, West Germany.

Annals of Neurology
|December 1, 1989
PubMed
Summary

Computed tomography (CT) patterns help distinguish embolic strokes from other brain lesions. Most embolic strokes show pial artery territorial infarction on CT, while lacunar infarcts are rarely embolic.

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Area of Science:

  • Neurology
  • Radiology
  • Cardiology

Background:

  • Distinguishing stroke mechanisms is crucial for effective treatment.
  • Computed tomography (CT) is a key imaging modality for acute stroke assessment.
  • Embolic strokes, often cardiac in origin, require specific diagnostic criteria.

Purpose of the Study:

  • To identify CT patterns characteristic of embolic brain infarction.
  • To differentiate embolic lesions from hemodynamic or microangiopathic stroke patterns.
  • To evaluate the role of embolism in lacunar infarcts.

Main Methods:

  • Consecutive series of 60 patients with confirmed embolic strokes.
  • Analysis of CT findings in relation to stroke etiology.
  • Exclusion of hemodynamic and in situ thrombotic stroke mechanisms.

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Main Results:

  • Pial artery territorial infarction observed in 92% of patients on CT.
  • Cardiac disease identified as the source of embolism in a majority of cases.
  • Lacunar infarcts showed atypical features, questioning an embolic origin.
  • No low-flow infarction patterns were detected.

Conclusions:

  • Pial artery territorial infarction on CT strongly suggests an embolic mechanism, excluding in situ thrombosis.
  • Embolism is an unlikely cause for the majority of lacunar infarcts.
  • CT imaging patterns aid in elucidating stroke etiology.