1 Edward Mallinckrodt Institute of Radiology and the Department of Neurology, Washington University School of Medicine, 510 South Kingshighway Boulevard, St. Louis, Missouri 63110
Dr. Siegel
The frequency of abnormal brain scans in patients with cerebral vascular disease admitted to a stroke intensive care unit has been evaluated in relation to diagnosis, time after onset of symptoms, effect of delayed imaging and the degree of clinical neurological recovery. In patients with completed thromboembolic infarction, 33% had abnormal scans including 39% of those with hemispheric lesions and 14% with posterior fossa lesions. Completed hemorrhagic infarction occurred in seven patients, and three (43%) had abnormal brain scans. Of 14 patients with either transient ischemic attacks or reversible ischemic neurological deficit, two (14%) had abnormal scans. Twenty-seven percent of brain scans in patients with completed thromboembolic infarction were abnormal in the first two days after infarction, a higher frequency than previously reported. Delayed images confirmed the initial interpretation that the scan was either normal or abnormal in 71% of the cases while in 10% of the cases only the delayed views were abnormal. The frequency of abnormal scans was significantly greater in patients who died or had a large neurological deficit at discharge than in patients with lesser residual deficit.
© 1975 American Heart Association, Inc.
Brain Scanning in Cerebral Vascular Disease: A Reappraisal
Key Words: cerebral infarction • cerebral hemorrhage • transient ischemic attack • neurological deficit • 99m Tc-pertechnetate • delayed brain imaging