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Related Experiment Video

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Author Spotlight: Integrated Photoacoustic, Ultrasound, and Angiographic Tomography (PAUSAT) for NonInvasive Whole-Brain Imaging of Ischemic Stroke
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CT perfusion: stroke, seizure or both?

Elizebath Davies1, Fathalla Elnagi2, Thomas Smith1

  • 1St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, UK.

BMJ Case Reports
|December 31, 2021
PubMed
Summary

This case study discusses an acute stroke diagnosis complicated by seizure activity. Multimodal imaging is crucial for differentiating stroke mimics and optimizing emergency care.

Keywords:
geriatric medicinestroke

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Area of Science:

  • Neurology
  • Radiology
  • Emergency Medicine

Background:

  • Acute stroke care relies on multimodal imaging for diagnosis and management.
  • Differentiating vascular events from stroke mimics is critical.
  • Seizures can mimic or complicate acute stroke presentations, causing diagnostic challenges.

Observation:

  • An 88-year-old male presented with acute ischemic stroke symptoms (NIHSS 19).
  • Initial CT showed small vessel disease and calcification; thrombolytic therapy was administered.
  • CT perfusion suggested seizure activity, not large vessel occlusion, despite stroke symptoms.

Findings:

  • Post-thrombolysis, NIHSS improved to 5.
  • MRI confirmed bilateral thalamic infarcts.
  • The patient experienced cognitive impairment post-rehabilitation.

Implications:

  • Multimodal imaging is essential for accurate acute stroke diagnosis and management.
  • Recognizing seizure activity as a stroke mimic is vital for appropriate treatment.
  • Sophisticated imaging interpretation by clinicians is necessary in complex stroke cases.