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A Change of Heart: Yield of Cardiac Imaging in Acute Stroke Workup

Frans Kauw1, Jan W Dankbaar1, Jesse Habets1

  • 1Department of Radiology, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.

Case Reports in Neurology
|June 22, 2018
PubMed

Insights

A patient experienced a recurrent ischemic stroke due to cardiac embolism. Dual-energy computed tomography angiography revealed intracardiac thrombi, aiding diagnosis and management of stroke patients.

Area of Science:

  • Cardiology
  • Neurology
  • Radiology

Background:

  • Recurrent ischemic stroke poses a significant clinical challenge.
  • Identifying the source of cardioembolism is crucial for effective stroke management.

Observation:

  • A patient presented with recurrent ischemic stroke within 24 hours.
  • Dual-energy computed tomography (DECT) angiography identified two intracardiac thrombi: one in the left ventricle and one in the left atrial appendage.

Findings:

  • Repeated DECT angiography after the second stroke showed significant reduction of the ventricular thrombus.
  • This finding strongly suggested cardioembolism as the cause of recurrent brain infarction.

Implications:

  • Cardiac evaluation using CT angiography can be beneficial in acute stroke settings.
  • DECT angiography is valuable for thrombus detection and differentiating thrombus from myocardial tissue and slow contrast flow.

Keywords:
Acute stroke imagingCardioembolic strokeComputed tomography angiographyDual-energy computed tomographyIschemic strokeRecurrent stroke

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