Abstract:
Stroke is the second leading cause
of death in the 60+ age group, the fifth leading cause of death in the 15-59 age group, and the
leading cause of permanent disability in adults in industrialized countries worldwide [1, 2, 3].
Acute ischemic stroke (AIS) accounts for about 85-90% of all strokes, about 10% are intracranial
hemorrhages, and about 3% are strokes with subarachnoid hemorrhage. Posterior AIS represents
18-20% of all acute ischemic strokes [1, 2, 4, 5, 6]. Over 70% of stroke survivors and over 50%
of stroke deaths are attributed to acute brain ischemia [6].
Thanks to the advantages (availability, speed and ability to present intracranial
hemorrhage) that CT, compared to other imaging investigations, offers for the examination of
stroke patients, a comprehensive three-component imaging protocol was developed – NCCT
(non-contrast computed tomography), followed by ACT (angiography computed tomography)
and PCT (perfusion computed tomography). Multimodal CT imaging in acute stroke can provide
all the necessary information about the anatomy of the brain, the state of the cerebral vessels, the
characteristics of the thrombus and the cerebral tissue hemodynamics before the administration
of reperfusion treatment, thus avoiding an additional imaging study [3, 7].
Predicting long-term clinical outcomes in AIS is important, but it is not easy when we
rely solely on patient symptoms, clinical signs, and NCCT. The results of recently published
investigations on dynamic Perfusion CT exam found the feasibility and perspective of this
method for rapid assessment of patients with AIS. PCT imaging, being a faster, accessible, more
widely available diagnostic tool, relatively inexpensive and with proven benefits, offers practical
advantages. PCT provides important parameters that significantly increase the accuracy of stroke
diagnosis, regardless of the location (anterior or posterior circulation), predict disease outcome,
present information on the blood–brain barrier (BBB) permeability and Hemorrhagic
transformation (HT) riak, allow correct selection of patients for reperfusion treatment [7]. [...]
