Computed tomography perfusion as a diagnostic tool for seizures after ischemic stroke

Area of Science:

• Neurology
• Radiology
• Stroke Medicine

Background:

• Cerebral cortical ischemia is a known risk factor for post-stroke seizures.
• The optimal imaging technique for identifying cortical ischemia and predicting seizures remains unclear.

Purpose of the Study:

• To compare CT perfusion (CTP) with non-contrast CT (NCCT) in detecting cortical ischemia.
• To evaluate the correlation between imaging findings and the occurrence of post-stroke seizures.

Main Methods:

• Patients with acute ischemic stroke were analyzed.
• Cortical involvement was assessed using NCCT and CTP parameters (T max, cerebral blood volume [CBV], cerebral blood flow [CBF]).
• The association between imaging findings and post-stroke seizures was statistically examined.

Main Results:

• CTP demonstrated higher sensitivity and specificity for detecting cortical involvement compared to NCCT.
• Cerebral blood volume (CBV) on CTP showed the highest hazard ratio for post-stroke seizures.
• CTP parameters, particularly CBV, offered superior predictive value for seizures than NCCT.

Conclusions:

• CT perfusion imaging enhances the detection of cortical involvement associated with post-stroke seizures.
• CTP offers improved diagnostic accuracy for predicting seizure risk in acute ischemic stroke patients compared to NCCT.