CT angiography | STROKE MANUAL

CT angiography (CTA)

NEUROIMAGING / COMPUTED TOMOGRAPHY Computed tomography angiography (CTA) David Goldemund M.D.Updated on 10/04/2024, published on 21/03/2021 [toc] CT angiography (CTA) is a fast (∼ 5 minutes), readily available, and non-invasive imaging modality used to assess both extra- and intracranial arteries it is based on the spatial reconstruction of images from a series of axial scans ... Read more

Digital subtraction angiography (DSA)

NEUROIMAGING / DSA Digital subtraction angiography (DSA) David Goldemund M.D.Updated on 13/12/2023, published on 03/05/2021 [toc] Digital Subtraction Angiography (DSA) is a fluoroscopic technique used to visualize the vascular system. Structures such as bone are digitally subtracted from the image, allowing for better visualization of blood vessels the Seldinger method is used to access the ... Read more

Aortic dissection

OTHER VASCULAR DISORDERS Aortic dissection David Goldemund M.D.Updated on 07/11/2023, published on 05/05/2023 [toc] the aorta is the main artery of the human body, divided by the diaphragm into the thoracic and abdominal segments in healthy adults, the aorta is usually less than 40 mm in diameter and gradually narrows downwards aorta increases its diameter ... Read more

Arterial dissection

ISCHEMIC STROKE / CLASSIFICATION AND ETIOLOGY Arterial dissection David Goldemund M.D.Updated on 18/03/2024, published on 05/05/2023 [toc] ESO guidelines for the management of extracranial and intracranial artery dissection (2021) Treatment and Outcomes of Cervical Artery Dissection in Adults: A Scientific Statement From the AHA (2024) Definition and pathophysiology arterial dissection is characterized by a tear ... Read more

Carotid endarterectomy (CEA)

Surgical treatment of an acute ischemic stroke

ISCHEMIC STROKE / PREVENTION Carotid endarterectomy (CEA) David Goldemund M.D.Updated on 26/04/2024, published on 31/01/2023 [toc] carotid endarterectomy (CEA) is the gold standard for treating significant carotid artery stenosis (both symptomatic and asymptomatic) randomized trials have confirmed that CEA is more effective than conservative treatment: symptomatic stenosis (NASCET, ECST, joint data analysis of ACTS, NASCET, ... Read more

CT perfusion (CTP)

CTP mismatch and final infarction after succesfull recanalisation of dominant M2 occlusion

NEUROIMAGING / COMPUTED TOMOGRAPHY CT perfusion (CTP) David Goldemund M.D.Updated on 29/04/2024, published on 21/12/2022 [toc] brain infarction is the consequence of a localized decrease in cerebral blood flow (CBF) CT perfusion (CTP) can be used to assess cerebral blood flow and differentiate the penumbra (salvageable brain tissue) from the core (area of damaged brain ... Read more

Early management of patients with suspected stroke

Infarct caused by the P2 segment occlusion

GENERAL THERAPY Early management of patients with suspected stroke David Goldemund M.D.Updated on 02/03/2024, published on 07/06/2022 [toc] any patient experiencing rapidly evolving neurological deficits should be evaluated as a potential candidate for recanalization therapy and transported ASAP to the nearest Stroke Center (SC) or Comprehensive Stroke Center (CSC) for urgent diagnostic evaluation and treatment ... Read more

Computed tomography (CT) in stroke diagnosis

NEUROIMAGING / COMPUTED TOMOGRAPHY Computed tomography (CT) in stroke diagnosis David Goldemund M.D.Updated on 02/01/2024, published on 21/03/2021 [toc] computed tomography (CT) is essential in the management of patients with acute neurological deficits because of its rapid acquisition and immediate availability of results, it is usually the primary imaging modality used to rule out bleeding ... Read more

Unfavorable vascular anatomy during endovascular treatment

ADD-ONS Unfavorable vascular anatomy during endovascular treatment David Goldemund M.D.Updated on 10/04/2024, published on 27/03/2024 [toc] → general overview of anatomical variants of cerebral arteries Introduction endovascular treatment includes acute stroke procedures (mechanical recanalization, local thrombolysis) and elective preventive procedures (CAS, intracranial stenting, aneurysm coiling, etc.) performing intravascular procedures can be challenging when the patient ... Read more

Carotid-cavernous fistula (CCF)

Direct CCF with rapid filling of ophtalmic veins on DSA

INTRACEREBRAL HEMORRHAGE / VASCULAR MALFORMATIONS Carotid cavernous fistula (CCF) David Goldemund M.D.Updated on 11/03/2024, published on 01/02/2024 [toc] carotid cavernous fistula is a specific variant of arteriovenous fistula (→ DAVF) - it is defined as a pathological communication between the cavernous sinus (CS) and the internal carotid artery (ICA) or its branches (from either the ... Read more