This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Verro, P. Articles by Eshkar, N. Search for Related Content PubMed PubMed Citation Articles by Verro, P. Articles by Eshkar, N. Pubmed/NCBI databases Medline Plus Health Information CT Scans Stroke Related Collections Acute Cerebral Infarction Angiography Computerized tomography and Magnetic Resonance Imaging

(Stroke. 2002;33:276.)
© 2002 American Heart Association, Inc.

Research Reports

CT Angiography in Acute Ischemic Stroke

Preliminary Results

Piero Verro, MD; Lawrence N. Tanenbaum, MD; Neil M. Borden, MD; Souvik Sen, MD Noam Eshkar, MD

From the University of California at Davis School of Medicine, Sacramento (P.V.), Seton Hall University School of Graduate Medical Education, South Orange, NJ (L.N.T., S.S., N.E.), New Jersey Neuroscience Institute (L.N.T., S.S., N.E.), and the Department of Radiology, Baylor University Medical Center, Dallas, Tex (N.M.B.).

Correspondence to Piero Verro, MD, University of California at Davis Medical Center, 2315 Stockton Blvd, Room 5308, Sacramento, CA 95817. E-mail piero.verro{at}ucdmc.ucdavis.edu

Abstract

Background and Purpose— We sought to evaluate the ability of CT angiography (CTA) to determine vessel occlusion before acute stroke treatment and to predict its impact on patient outcome.

Methods— Consecutive patients with acute focal neurological deficits received immediate brain CTA. Occlusion on CTA was correlated with other neuroimaging studies and clinical outcome.

Results— Diagnostic CTA was obtained in 54 patients: catheter angiography (digital subtraction angiography) confirmed the CTA findings in 12 of 14 patients (86%). CTA results were consistent with at least 1 other neuroimaging study in 40 of 50 patients (80%). Patients with occlusion on CTA had significantly worse discharge National Institutes of Health Stroke Scale (NIHSS) score (mean 14.3 versus 4.5, P=0.0023). In multivariate analysis, both CTA-determined presence of occlusion and admission NIHSS score were independent predictors of clinical outcome.

Conclusions— In our study there was good agreement between acute CTA interpretation and subsequent imaging studies. CTA evidence of occlusion correlated strongly and independently with poor clinical outcome. CTA provides relevant data regarding vessel patency in acute stroke, which may be of value in selecting patients for aggressive treatment.

Key Words: cerebrovascular disorders • neurology • radiology • stroke

This article has been cited by other articles:

				M. Wintermark, H. A. Rowley, and M. H. Lev Acute Stroke Triage to Intravenous Thrombolysis and Other Therapies with Advanced CT or MR Imaging: Pro CT Radiology, June 1, 2009; 251(3): 619 - 626. [Full Text] [PDF]

				A. M. Brunser, P. M. Lavados, A. Hoppe, J. Lopez, M. Valenzuela, and R. Rivas Accuracy of Transcranial Doppler Compared With CT Angiography in Diagnosing Arterial Obstructions in Acute Ischemic Strokes Stroke, June 1, 2009; 40(6): 2037 - 2041. [Abstract] [Full Text] [PDF]

				J. M. Provenzale and M. Wintermark Optimization of Perfusion Imaging for Acute Cerebral Ischemia: Review of Recent Clinical Trials and Recommendations for Future Studies Am. J. Roentgenol., October 1, 2008; 191(4): 1263 - 1270. [Abstract] [Full Text] [PDF]

				H. P. Adams Jr, G. del Zoppo, M. J. Alberts, D. L. Bhatt, L. Brass, A. Furlan, R. L. Grubb, R. T. Higashida, E. C. Jauch, C. Kidwell, et al. Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Circulation, May 22, 2007; 115(20): e478 - e534. [Abstract] [Full Text] [PDF]

				H. P. Adams Jr, G. del Zoppo, M. J. Alberts, D. L. Bhatt, L. Brass, A. Furlan, R. L. Grubb, R. T. Higashida, E. C. Jauch, C. Kidwell, et al. Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/ American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists Stroke, May 1, 2007; 38(5): 1655 - 1711. [Abstract] [Full Text] [PDF]

				A. Waaijer, M. Prokop, B. K. Velthuis, C. J. G. Bakker, G. A. P. de Kort, and M. S. van Leeuwen Circle of Willis at CT Angiography: Dose Reduction and Image Quality--Reducing Tube Voltage and Increasing Tube Current Settings Radiology, March 1, 2007; 242(3): 832 - 839. [Abstract] [Full Text] [PDF]

				J. R. Sims, G. Rordorf, E. E. Smith, W. J. Koroshetz, M. H. Lev, F. Buonanno, and L. H. Schwamm Arterial Occlusion Revealed by CT Angiography Predicts NIH Stroke Score and Acute Outcomes after IV tPA Treatment AJNR Am. J. Neuroradiol., February 1, 2005; 26(2): 246 - 251. [Abstract] [Full Text] [PDF]

				M. Nakajima, K. Kimura, T. Ogata, T. Takada, M. Uchino, and K. Minematsu Relationships between Angiographic Findings and National Institutes of Health Stroke Scale Score in Cases of Hyperacute Carotid Ischemic Stroke AJNR Am. J. Neuroradiol., February 1, 2004; 25(2): 238 - 241. [Abstract] [Full Text] [PDF]

				M. Kaste Reborn Workhorse, CT, Pulls the Wagon Toward Thrombolysis Beyond 3 Hours Stroke, February 1, 2004; 35(2): 357 - 359. [Full Text] [PDF]

				J. F. Meschia, D. A. Miller, and T. G. Brott Thrombolytic Treatment of Acute Ischemic Stroke Mayo Clin. Proc., June 1, 2002; 77(6): 542 - 551. [Abstract] [PDF]