Stroke CT
CT is the first-line imaging modality used in neurologic emergencies owing to its speed, accurate depiction of acute intracranial disease, and availability. The critical role of nonenhanced CT for stroke evaluation began in 1996, when the U.S. Food and Drug Administration (FDA) approved intravenous tissue plasminogen activator (tPA) for clot thrombolysis - Christopher A. Potter MD

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The role of CT and MR in stroke patients
Currently, non-contrast CT is the primary choice for the initial evaluation of patients suspected of stroke. CT is widely available, a scan can be made within a minute, and unstable patients are easier to manage in a CT scanner than in an MR scanner. Thereby, most of the time an NCCT provides enough information to differentiate between ischemic and hemorrhagic stroke, that is, if imaging takes place within a few hours after stroke onset. Within that time, there exist tangible indications of early ischemia e.g., loss of differentiation between gray and white matter and subtle signs of swelling. CT is the first-line imaging modality used in neurologic emergencies…
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CT for Treatment Selection in Acute Ischemic Stroke: A Code Stroke Primer
Nonenhanced CT should be performed rapidly in patients with signs and symptoms of acute stroke to exclude intracranial hemorrhage (ICH) and identify large (ie, >100 mL or more than one-third of a brain territory at risk) well-established infarcts
Articles of Interest
After Stroke Scans, Patients Face Serious Health Risks
The cases come at a time when Americans are receiving more medical radiation than ever before, a result of rapid technological advancements that improve diagnosis but can also do harm when safeguards and oversight fail to keep pace.
Comparison of CT and MR imaging in ischemic stroke
In comparing the use of CT versus MRI in the workup of ischemic stroke, a number of factors come under consideration. When ultrafast CT scanners covering almost the entire brain are used, the potential to detect ischemia and salvageable tissue is almost equal in both techniques. The major drawback of CT is the high radiation dose, while in MRI it is the more complicated and time consuming aspect of the examination. Thus, if any general practical recommendation can be made, acute stroke patients should be evaluated by native CT followed by PCT, with MRI reserved for more chronic cases of brain ischemia or control examinations in stroke patients.
Imaging of Ischemic Stroke
Noncontrast CT is the most widely used first-line imaging tool in patients with acute stroke and is recommended as an initial mode of imaging to assist in making decisions for IV tissue plasminogen activator.
Imaging of Stroke: Part 1, Perfusion CT???Overview of Imaging Technique, Interpretation Pearls, and Common Pitfalls
Perfusion CT is being increasingly used as a diagnostic tool for the evaluation of acute ischemic stroke. It can be performed rapidly and aids in the detection of salvageable tissue (penumbra) from the unsalvageable core infarct.
Resources
RadiologyInfo.org
CT imaging is sometimes compared to looking into a loaf of bread by cutting the loaf into thin slices. When the image slices are reassembled by computer software, the result is a very detailed multidimensional view of the body's interior.

