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Computed Tomographic-Angiographic Findings within the First Five Hours of Cerebral Infarction
Stroke 22:1245-1253, Horowitz,S.H.,et al, 1991
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Article Abstract
Acute abnormalities,hypodensity,and mass effect were seen in 56%of scans and confirmed on a second scan 5-7 days later.Intracranial angiographic abnormalities occurred in 61%of patients:arterial occlusions in 45%and delayed arterial filling in 16%.Hemorrhagic infarctions occurred in 26^of second scans and were associated with mass effect(100%)and arterial occlusions(89%).Infarcts with hemorrhagic transformation were larger on both scans than those without(p=0.001).Of four patients with infarctions in watershed territories on the scans,two had middle cerebral artery occlusions on angiography,thereby questioning the specificity of such scan lesions to low-flow states.We conclude that cerebral infarctions are often visible on early scans,but their locations may not be etiologically determinative.The infarcts associated with intracranial arterial occlusions(45%)were of thromboembolic origin,but,given current controversies as to the pathophysiology of lacunar and watershed infarctions,we cannot ascertain the etiology in the remainder.These findings are relevant to the new stroke therapies that require administration in the first hours after infarction.
 
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angiography,cerebral
CAT scan
CAT scan,abnormal
CAT scan,cerebrovascular disease
CAT scan,early changes in CVA
cerebral infarction
cerebrovascular accident

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