Stroke Imaging

Excerpt

Stroke or cerebrovascular accident (CVA) is an acute central nervous system (CNS) injury and one of the leading causes of death in the developed world. Estimates are that the incidence of stroke is 795000 each year, which causes 140000 deaths annually. Based on the Center for Disease Control and Prevention (CDC) report, stroke has moved from third place in 2007 to the fifth leading cause of death in 2017 in the United States. Among the strokes that occur in the U.S., approximately 87% are ischemic, 10% are intracerebral hemorrhagic (ICH) strokes, and 3% are aneurysmal subarachnoid hemorrhages (SAH). In the past, neuroimaging was mainly done to exclude hemorrhagic, neoplastic, and infectious etiologies from the ischemic cause of strokes and there was a limited role for diagnostic and therapeutic efficacy of neuroimaging and interventional neuroradiology in the acute management of strokes. With recent advances, neuroimaging is now a critical part of stroke management. Despite advancements in the field of neuroradiology and interventional neuroradiology in the early management of acute stroke and decline in the mortality and morbidity rate in recent years, disability and long-term complications of stroke remain high and cost more than $34 billion each year in the U.S.

Neuroimaging in stroke patients, especially in acute ischemic stroke patients, plays an essential role. It helps to differentiate other causes of stroke (i.e., stroke mimics such as migraine headache, tumors, seizure, metabolic disturbance, and peripheral or cranial nerve disorders), early detection of hemorrhagic stroke, distinguishing irreversible infarcted tissues from salvageable tissue, identification of vascular malformations, treatment planning for intravenous thrombolysis and intra-arterial thrombectomy, and outcomes prediction. This activity presents a review of the different modalities and advances imaging techniques in the diagnosis and management of stroke.