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Accident vascular cerebral

Accident vascular cerebral . Accident ischemic sau hemoragic ? Daca e ischemie : tromboliza ? Daca e hemoragic : care e etiologia si tratamentul cauzei Urgenta extrema este ischemia Urgenta rapida esta hemoragia. Accident vascular cerebral . Diagnostic diferential Diagnostic pozitiv

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Accident vascular cerebral

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  1. Accident vascular cerebral • Accident ischemic sau hemoragic ? • Daca e ischemie : tromboliza ? • Daca e hemoragic : care e etiologia si tratamentul cauzei • Urgenta extrema este ischemia • Urgenta rapida esta hemoragia

  2. Accident vascular cerebral • Diagnostic diferential • Diagnostic pozitiv • Este o ocluzie a unei artere cerebrale ? • Este indicata tromboliza ?

  3. SEMIOLOGIA CT A MODIFICARILOR de DENSITATE ale PARENCHIMULUI CEREBRAL • hiperdensitate a unei artere cerebrale, • stergerea santurilor intergirale intr-un teritoriu arterial, • pierderea diferentierii intre substanta alba si substanta cenusie superficial sau profund,

  4. H 5 H 4 H 8 «mici» semne de ischemie Sensibilitate 100 % Hipodensitate EDEMUL CITOTOXIC in stadiile supra-acute ?

  5. 48 heures Accident ischemic la 3 ore TDM FLAIR Diffusion ADC

  6. Accident ischemic la 3 ore Perfusion Flair Diffusion Evolutia fara tratament dupa 2 zile

  7. CT • Diagnostic pozitiv : semne tardive • Disparitia disocierii intre substanta gri si cea alba • Diagnostic dif.: hemoragie • Ocluzia arterei : angio-CT • Indicatie de tromboliza : CT de perfuzie

  8. Dédifférenciation gris-blanc

  9. Ischémie : H5 Angioscanner : siège de l ’occlusion

  10. Ischémie : J2

  11. Ischémie > 3ème semaine

  12. Cautarea etiologiei • la 24 – 48 h • Artere cervicale si cerebrale: • Echo-Doppler • Angio-scanner • Etiologie cardiaca : • Trouburari de ritm : ECG, Holter • Leziuni cardiace : ecocardiografia transtoracica/transoesofagiana

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