doi: 10.1161/hs0102.101223
(Stroke. 2002;33:276.)
© 2002 American Heart Association, Inc.
Research Reports |
CT Angiography in Acute Ischemic Stroke
Preliminary Results
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
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