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[Stroke-like events with negative computer-tomographic findings]
Insights
Cranial computed tomography (CT) is vital for diagnosing strokes, identifying hemorrhages and hematomas. Early CT can detect subtle signs of stroke, even when initial results are negative.
Area of Science:
- Neurology
- Radiology
Background:
- Cranial computed tomography (CT) is a key diagnostic tool for suspected strokes.
- It complements cardiac, circulatory, and carotid artery assessments.
Observation:
- A study analyzed 917 patients undergoing ambulant CT for suspected stroke.
- Positive CT findings were observed in 662 cases, including intracerebral hemorrhages and subdural hematomas.
Findings:
- In 234 cases with initially negative CT, diagnoses included transient ischemic attacks, early-stage cerebral infarctions, and spinal conditions.
- Primary CT is crucial within 8 hours for suspected extracranial carotid stenosis to rule out hemorrhage or tumors.
Implications:
- Secondary CT is most effective on the sixth or seventh day post-attack to avoid fogging effects.
- CT imaging plays a critical role in the timely and accurate diagnosis of various cerebrovascular events.
Abstract:
In addition to cardiac and circulatory check-up and sonography of the arteries ascending to the brain, cranial computed tomography is essential for diagnosing strokes, preceding even arteriography. In 917 patients with suspected stroke who had been referred for ambulant computed tomography, catamnestic analyses were performed. Among 662 cases with positive CT findings there were 41 intracerebral hemorrhages and 6 subdural hematomas. In 234 cases, in which the computed tomography initially revealed no circumscribed cerebral infarction, transient ischemic attacks, insults of the cerebral trunk, insults of the cerebrum at an early stage, minor insults in cases of preceding vascular cerebral damage, prolonged reversible neurological deficits (PRIND) as well as vascular or tumorous spinal processes were present (in descending order). In cases of extracranial stenosis of the arteria carotis within the 8-hour interval, primary computed tomography is indicated to exclude hemorrhages or tumors. The sixth or seventh day following an attack is otherwise most suitable to perform secondary computed tomography, since fogging effect may occur later on.