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Changes On CT Scan In Ischaemic Stroke

Changes On CT Scan In Ischaemic Stroke. Nadine MacCowan. CT Changes In Ischaemic Stroke. When there is ischaemia in the brain the water content of the affected brain tissue increases and it swells Ischaemia causes low attenuation and so the affected brain tissue is darker than usual

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Changes On CT Scan In Ischaemic Stroke

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  1. Changes On CT Scan In Ischaemic Stroke Nadine MacCowan

  2. CT Changes In Ischaemic Stroke • When there is ischaemia in the brain the water content of the affected brain tissue increases and it swells • Ischaemia causes low attenuation and so the affected brain tissue is darker than usual • Changes can’t be seen immediately – usually takes 12-18 hours so very early ischaemic changes may not be seen

  3. Early CT Changes In Ischaemic Stroke • Loss of insular ribbon • Loss of grey-white interface • Loss of sulci • Acute hypo density • Mass effect • Dense MCA sign

  4. Late CT Changes In Ischaemic Stroke • Associated oedema with midline shift may be present • After 24 - 48 hours irregular enhancement of the cortex appears

  5. Ischaemic Stroke Does Not Alter CT For Several Hours • These patients need treatment to reestablish as much blood flow as possible to prevent cell death and permanent loss of function • However – still need to wait for CT changes to make sure it is an ischaemic and not a haemorrhagic stroke

  6. Anterior Cerebral Artery Ischaemic Stroke • Blockage in anterior cerebral artery • Stops supply of blood to top of the cortex, internal capsule, caudate nucleus and lentiform nucleus

  7. Anterior Cerebral Artery Ischaemic Stroke

  8. Anterior Cerebral Artery Ischaemic Stroke • Not very common • Typical symptoms: • Hemiplegia/hemiparesis • Neglect (right hemisphere damage) • Aphasia and apraxia (left hemisphere damage) • Sensory loss • Urinary incontinence • Mental status impairment

  9. Middle Cerebral Artery Ischaemic Stroke • Blockage in middle cerebral artery • Stops supply of blood to lateral hemispheres, the biggest portion of the cerebral cortex

  10. Middle Cerebral Artery Ischaemic Stroke

  11. Ischaemic Stroke In Posterior Branch Of Middle Cerebral Artery

  12. Middle Cerebral Artery Ischaemic Stroke • Very common • Typical symptoms: • Contralateral hemiparesis • Dysarthria • Dysphasia (if dominant) • Dysphagia • Dysgraphia/dyslexia • Hemianopia

  13. Posterior Cerebral Artery Ischaemic Stroke • Blockage in posterior cerebral artery • Stops supply of blood to thalamus, lentiform nucleus, medial geniculates, medial temporal lobe, occipital lobe and choroid plexus

  14. Posterior Cerebral Artery Ischaemic Stroke

  15. Posterior Cerebral Artery Ischaemic Stroke • Typical symptoms: • Visual deficits (e.g. hemianopia) • Memory deficits • Alexia/dyslexia

  16. Internal Carotid Artery Ischaemic Stroke • Blockage in internal carotid artery • Divides to form anterior and middle cerebral arteries so has huge effect on brain

  17. Anterior and Middle Cerebral Artery Infarction Following Internal Carotid Artery Occlusion

  18. Internal Carotid Artery Ischaemic Stroke • Typical Symptoms: • Ipsilateral blindness • Dysphasia • Spatial problems • Hemineglect

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