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ISRN Neuroscience - Volume 2014 2014, Article ID 654980, 4 pages -

Clinical Study

Department of Neurology, University of Tennessee, Memphis, TN 38163, USA

Department of Neurosurgery, Semmes-Murphey Neurologic and Spine Institute, University of Tennessee, Memphis, TN 38120, USA

Semmes-Murphey Clinic, 6325 Humphreys Boulevard, Memphis, TN 38120-2300, USA

Received 2 December 2013; Accepted 8 January 2014; Published 9 March 2014

Academic Editors: M. Jan, A. J. Nelson, and S. Rosahl

Copyright © 2014 Shraddha Mainali et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Noncontrast head CT NCCT is the standard radiologic test for patients presenting with acute stroke. Early ischemic changes EIC are often overlooked on initial NCCT. We determine the sensitivity and specificity of improved EIC detection by a standardized method of image evaluation Stroke Windows. Methods. We performed a retrospective chart review to identify patients with acute ischemic stroke who had NCCT at presentation. EIC was defined by the presence of hyperdense MCA-basilar artery sign; sulcal effacement; basal ganglia-subcortical hypodensity; and loss of cortical gray-white differentiation. NCCT was reviewed with standard window settings and with specialized Stroke Windows. Results. Fifty patients 42% females, 58% males with a mean NIHSS of 13.4 were identified. EIC was detected in 9 patients with standard windows, while EIC was detected using Stroke Windows in 35 patients 18% versus 70%; . Hyperdense MCA sign was the most commonly reported EIC; it was better detected with Stroke Windows 14% and 36%; . Detection of the remaining EIC also improved with Stroke Windows 6% and 46%; . Conclusions. Detection of EIC has important implications in diagnosis and treatment of acute ischemic stroke. Utilization of Stroke Windows significantly improved detection of EIC.

Autor: Shraddha Mainali, Mervat Wahba, and Lucas Elijovich



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