Early C.T. Signs of Cerebral infarction Correlation with T.C. D. findings

Abstract

Among 25 patients admitted to Ain Shams University Specialized Hospital, Stroke unit; subjected to complete physical examination and proper investigation our results showed that:

Hypertension, diabetes mellitus, transient ischemic attacks (TIAs), hypercholesterolemia, hypertriglyceridemia, cigarette smoking and reduced physical activity have been accused as cerebral infarction risk factors especially in advancing age.

So regular and systemic screening for cases past middle age is important to detect those with high risk factors for prevention and proper effective treatment.

CT scan:

The view that the CT scan is negative in the first 24-48 hours after the stroke has been handed down. * You should perform CT scan early as possible. * A normal CT scan within the first 2 hours does not exclude the possibility of a large infarct. * Repeat CT scan if initiation of thrombolytic therapy is delayed .

*What to be looked {or in the first CT scan ? a)The presence of a spot or tubular structure along the major intracranial vessels, particularly at the intracranial bifurcation of the JCA, along the main trunk of the MCA which is hyperdense in relation to the remainder of that vessels or to other vessels .

b) The presence of precocious parenchymal hypodensity of the basal ganglia and/or the cortex (gray matter hypodensity to the gray scale of white matter), associated or not with sulcal effacement or ventricular compression .

c) The presence of parenchymal hyperdensity which might represent parenchymal hemorrhage ; hemorrhage may be tiny in the early stage.

d) The presence of previous ischemic brain damage. The pattern could indicate the underlying disease . (Von Kummer, Bozzao, Manelfe 1995)