Document Detail


Rate of arterial occlusion in patients with acute ischemic stroke.
MedLine Citation:
PMID:  18826810     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Computed tomographic angiography (CTA) was invented more than 20 years ago, but only gained acceptance recently, thanks to advancements in the computer technology. It can demonstrate areas of arterial stenosis or occlusion with accuracy nearly that of digital subtraction angiography (DSA). It is also able to clearly illustrate calcification, which is more difficult to define on magnetic resonance angiography and is not clearly depicted on DSA. METHODS: Our retrospective study attempted to clarify the rate of occlusion or stenosis in the patients with acute ischemic stroke. RESULTS: Over the period of 7 months, 93 consecutive patients were admitted with acute ischemic stroke. Fifty-six patients underwent CTA and were included in this study. Most of the patients were admitted after 6 hours following onset of symptoms. There were 28 men and 28 women, and 80.4% of the cohort was of African-American origin. The majority of strokes were attributed to small-vessel disease (25/56). The rest of the cases were deemed secondary to atheroembolism (15/56), cardioembolism (9/56) or of unclear etiology (7/56). In 24 (42.9%) patients, CTA failed to reveal any abnormalities of the cerebrovascular tree. CTA demonstrated arterial occlusion in ten (17.9%) patients and stenosis of extracranial or intracranial arteries on the symptomatic side in 22 (39.2%) patients. There was very good correlation between CTA and ultrasound techniques (carotid duplex and transcranial Doppler). CTA was superior in demonstrating distal intracranial stenosis. CONCLUSION: Overall, CTA is an extremely valuable and fast way to emergently evaluate the cerebrovascular anatomy, making it very useful for pre-thrombolysis evaluation of patients with ischemic stroke.
Authors:
Alexander Y Zubkov; Hartmut Uschmann; Alejandro A Rabinstein
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurological research     Volume:  30     ISSN:  0161-6412     ISO Abbreviation:  Neurol. Res.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-01     Completed Date:  2008-11-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7905298     Medline TA:  Neurol Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  835-8     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Mississippi Medical Center, Jackson, MS, USA. zubkov.alexander@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angiography, Digital Subtraction / methods*,  standards
Arterial Occlusive Diseases / diagnosis,  radiography,  ultrasonography
Brain Ischemia / diagnosis*,  radiography,  ultrasonography
Cerebral Angiography / methods*,  standards
Embolism, Cholesterol / diagnosis,  radiography,  ultrasonography
Female
Humans
Intracranial Arteriosclerosis / diagnosis,  radiography,  ultrasonography
Male
Middle Aged
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Stroke / diagnosis*,  radiography,  ultrasonography
Time Factors
Tomography, X-Ray Computed / methods*,  standards
Ultrasonography, Doppler, Transcranial / methods,  standards

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