Imaging of Vascular Diseases of the Brain

Question 1

What radiologic test is used to diagnose carotid artery disease?

Answer 1

Ultrasound

Question 2

24 hours to 1 week describes what age of an ischemic stroke?

Answer 2

Acute

Question 3

What imaging study may be conducted to determine the age of a hemorrhage?

Answer 3

MRI - blood products appear differently on MRI due to degradation time

Question 4

Unmanaged hypertension is most associated with what type of hemorrhagic stroke?

Answer 4

Intraparenchymal hemorrhage

Question 5

Where are nearly all (90%) brain aneurysms found?

Answer 5

Anterior circulation, with most in the ACA & Anterior Communicating Artery

Question 6

True/False. Ischemic stroke may transform into a hemorrhagic stroke.

Answer 6

True. Vessels dilate and neovascularization occurs due to an ischemic stroke. This may, in turn, cause a hemorrhagic stroke

Question 7

What signs on a CT image are associated with hyperacute ischemic stroke?

Answer 7

Insular ribbon sign (loss of gray-white matter differentiation) & hyperdense MCA

Question 8

Early hyperacute refers to what time following an ischemic stroke?

Answer 8

0-6 hours

Question 9

What radiologic tests are used to diagnose and follow vascular diseases?

Answer 9

CT (CTA) & MRI (MRA) Angiography

Question 10

Late hyperacute refers to what time following an ischemic stroke?

Answer 10

6-24 hours

Question 11

Weeks 1-3 following a stroke are described as what age?

Answer 11

Subacute stroke

Question 12

Subarachnoid hemorrhage is most associated with what pathology?

Answer 12

Ruptured aneurysm & trauma

Question 13

What imaging test should be ordered if a brain aneurysm is expected?

Answer 13

CTA (CT Angiography)

Question 14

An MRI is used to confirm acute ischemic stroke. What type of MRI is run?

Answer 14

Diffusion sequence - ischemia appears as a bright area

ADR sequence is the inverse of diffusion and ischemia appears dark. ADR is utilized to create the diffusion sequence image.

Question 15

What drug may be administered following an ischemic stroke, if the window for TPA has passed?

Answer 15

Aspirin

Question 16

What is the recommended treatment for intraparenchymal hemorrhage?

Answer 16

Generally, there is no treatment for hemorrhage. The cause of the hemorrhage (ex: high blood pressure) must be addressed, however

Question 17

True/False. Small vessel chronic ischemia often appears around the ventricles.

Answer 17

True. Smaller areas are impacted than in large vessel ischemia

Question 18

What segment of the middle cerebral artery is most prone to clots and easiest to treat?

Answer 18

Horizontal M1

Question 19

What is the best initial imaging test for any suspected intracranial pathology?

Answer 19

Head CT without contrast