MR-DWI in the acute stroke diagnosis

Hemorrhagic transformation (DWI with T2 blackout)
NEUROIMAGING / MAGNETIC RESONANCE MR-DWI in the acute stroke diagnosis  Created 01.10.2019, last update 04.04.2022 [toc] ischemia leads to diffusion restriction (water molecules stay in the cells) because of energetic failure of Na+/K+ membrane pumps the intensity of each image element (voxel) on the DWI sequence reflects the degree of water diffusion ⇒ restricted diffusion ... Read more

Recanalization therapy in acute stroke

Recanalization therapy in acute stroke
ISCHEMIC STROKE / ACUTE THERAPY Recanalization therapy in acute stroke Created 16/09/2022, last revision 19/09/2022 [toc] Introduction Recanalization restoration of flow at the primary occlusion site AOL  Reperfusion restoration of anterograde flow in the vessels beyond the primary occlusion site (anterograde perfusion) TICI  Collateral circulation retrograde perfusion  Distal embolization new occlusion detected distal to the ... Read more

Early management of patients with suspected stroke

GENERAL THERAPY Early management of patients with suspected stroke Created 07/06/2022, last revision 05/09/2022 [toc] every patient with rapidly developing neurological deficits should be evaluated as a potential candidate for recanalization treatment and should be transported ASAP to the nearest stroke center or comprehensive stroke center for emergent diagnostic evaluation and therapy Definition and clinical ... Read more

Magnetic Resonance Imaging (MRI)

Magnetic resonance imaging
NEUROIMAGING / MAGNETIC RESONANCE IMAGING Magnetic Resonance Imaging (MRI) Created 27/05/2022, last revision 21/09/2022 [toc] MR imaging is based on the behavior of atoms (most often - H, P, and Na) in the magnetic field structures generating low signals are hypointense, structures generating high signals are hyperintense; tissues producing no signal are dark (blood, calcifications) ... Read more

Central retinal artery occlusion (CRAO)

Cherry red spot and pale retina in CRAO
ADD-ONS / OTHER VASCULAR DISORDERS Central retinal artery occlusion (CRAO) Created 26/04/2022, last revision 26/04/2022 [toc] AHA guidelines 2021 - Management of CRA occlusion Ocular vascular disorders Content available only for logged-in subscribers (registration will be available soon) Ophtalmic artery anatomy Content available only for logged-in subscribers (registration will be available soon) the central retinal ... Read more

Acute stroke in anticoagulated patient

Acute stroke in anticoagulated patient
ISCHEMIC STROKE / THERAPY Acute stroke in anticoagulated patient Created 18/04/2022, last revision 25/05/2022 anticoagulants have become the mainstay of stroke prevention in patients with atrial fibrillation or other potential sources of cardioembolism however, even with this therapy (including DOACs), ischemic stroke can occur, and we then address 2 basic scenarios in the acute phase: ... Read more

Gadolinium-based contrast agents (GBCAs)

Gadolinium-based contrast agents (GBCAs) enhance pathological lesions on MRI
NEUROIMAGING / MAGNETIC RESONANCE Gadolinium-based contrast agents (GBCAs) Created 11/04/2022, last revision 06/06/2022 [toc] 2020 - Consensus Guidelines of the French Society of Neuroradiology (SFNR) on the use of Gadolinium-Based Contrast agents (GBCAs) and related MRI protocols in Neuroradiology contrast agents facilitate the relaxation of hydrogen protons in water and thus shorten the T1 and ... Read more

Surgical treatment of an acute ischemic stroke

Surgical treatment of an acute ischemic stroke
ISCHEMIC STROKE / ACUTE THERAPY Surgical treatment of an acute ischemic stroke Created 27/01/2022, last revision 16/09/2022 Emergency carotid endarterectomy (< 24h) insufficient data on the effectiveness of the method in acute stroke  (AHA/ASA 2019 IIb/B-NR) surgical risk in neurologically unstable patients is increased, but good results were reported in case series; no RCTs are ... Read more

Cryptogenic stroke

Cryptogenic stroke
ISCHEMIC STROKE / CLASSIFICATION AND ETIOPATHOGENESIS CRYPTOGENIC STROKE Created 17/12/2021, last revision 26/09/2022 [toc] Definition of cryptogenic stroke cryptogenic stroke (CS) = stroke of an unknown etiology (a diagnosis of exclusion) TOAST 5   (a strict diagnostic algorithm is not defined) ASCOD (Atherosclerosis, Small Vessel Disease, Cardiac Causes, Other, and Dissection) CCS (Causative Classification system) ... Read more

Contrast-induced encephalopathy (CIE)

IMAGING METHODS Contrast-induced encephalopathy (CIE) Created 08/12/2021, last revision 17/09/2022 [toc] contrast-induced encephalopathy (CIE) is a rare neurological complication that occurs during or after the use of a contrast medium in various angiographic procedures coronary angiography, diagnostic cerebral DSA, CAS, EVT in acute stroke patients    (Chu, 2020) reported with the use of different contrast ... Read more
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