STROKE-CT, EARLY FINDINGS

SUMMARY

CT FINDINGS
1. Early hypodensity (unlikely < 4.5hr after onset)
2. Sulcal effacement
3. Loss of grey-white differentiation (particularly in the caudate/lentiform where the lenticulostriate arteries do not have collaterals)
4. Clot in the MCA artery (hyperdense artery)

CAUSES OF THE ABOVE FINDINGS
5. Cytotoxic edema: occurs within 3-6 hours, causes darker (hypodense) region where cortical density is not preserved and loss of grey-white differentiation.
6. Radiographic hyperdensity: high attenuation caused by clot within the MCA is visible early on CT.

7. Hemorrhage can occur within the infarcted region leading to hyperdensity within the hypodense region.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].