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Updated: Mar 29, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Computed tomography angiography in acute stroke (revisiting the 4Ps of imaging)
Shriram Varadharajan1, Jitender Saini1, Ullas V Acharya1
1Department of Neuroimaging and Interventional Radiology (NI & IR), National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India 560029.
Abstract:
Imaging in acute stroke has traditionally focussed on the 4Ps-parenchyma, pipes, perfusion, and penumbra-and has increasingly relied upon advanced techniques including magnetic resonance imaging to evaluate such patients. However, as per European Magnetic Resonance Forum estimates, the availability of magnetic resonance imaging scanners for the general population in India (0.5 per million inhabitants) is quite low as compared to Europe (11 per million) and United States (35 per million), with most of them only present in urban cities. On the other hand, computed tomography (CT) is more widely available and has reduced scanning duration. Computed tomography angiography of cervical and intracranial vessels is relatively simpler to perform with extended coverage and can provide all pertinent information required in such patients. This imaging review will discuss relevant imaging findings on CT angiography in patients with acute ischemic stroke through illustrated cases.
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