Ch 1 - Stroke: Diagnostics Flashcards

1
Q

How does an infarct appear on CT?

A

Black

Focally decreases density (hypodense) = darker than normal

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2
Q

When does an infarct appear on CT?

A

If mass effect then immediate
~24hr d/t edema
Best in 3-4 days

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3
Q

How does an infarct appear on MRI?

A

White

Edema/fluid= high signal density

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4
Q

When does an infarct appear on MRI?

A

Immediately as bright white on T2=edema= water

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5
Q

How does a hemorrhage appear on CT?

A

White

Hyperdense (radio-opaque)

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6
Q

When does a hemorrhage appear on CT?

A

Seen immediately

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7
Q

How does a hemorrhage appear on MRI?

A

Black (on T1 or T2)

Low density signal

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8
Q

What is the major role of using head CT in CVA?

A

Evaluating for presence of blood especially when thrombolysis is being considered

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9
Q

What is the study of choice for intracranial hemorrhage (ICH)?

A

CT head without contrast

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10
Q

When can a subarachnoid hemorrhage (SAH) be detected on CT?

A

Acute stage in 1st 4-5 days when blood is denser (white) than CSF

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11
Q

What is MRI better at detecting over CT in CVA?

A

Acute ischemic infarcts

Posterior cranial fossa infarcts

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12
Q

What is the most sensitive and specific imaging technique for acute infarctions?

A

Diffusion-weighted imaging (DWI) MRI

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13
Q

What is carotid US used for?

A

Screening for carotid stenosis

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14
Q

What is transcranial doppler US used for?

A

Velocity and direction of flow in Circle of Willis

Detects vasospasm and intracranial collateral pathways

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15
Q

What is angiography useful for diagnosing?

A
Aneurysms
Vascular malformations
Arterial dissections
Narrow/occluded vessels
Angiitis
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16
Q

What is the only certain means of diagnosing an aneurysm?

A

Carotid and vertebral angiography

17
Q

What is MRA reliable at detecting?

A

Extracranial carotid artery stenosis and patency of large cervical and basal vessels

18
Q

What is Transthoracic Echocardiography (TTE) useful for?

A

Quickly assess heart valves and ejection fraction

19
Q

What is Transesophageal Echocardiography (TEE) useful for evaluation?

A
Aorta
Pulmonary artery
Heart valves
Atria
Atrial septum
Left atrial appendage
Coronary arteries
Patent foramen ovale
20
Q

When should a lumbar puncture be done when evaluating for stroke?

A

Diagnosing SAH when head CT is not available or negative and clinical suspicion high