Neuroimaging methods in stroke

Stroke is characterized by a sudden onset of focal central neurological deficit, with symptoms lasting more than 24 hours, that can be fatal. The introduction of anti-coagulation treatments, together with continuous advances in neuroimaging techniques, are having a positive impact both on morbidity and mortality in stroke patients. It must be stressed that the ”therapeutic window” for fibrolytic treatment is up to 6 hours. Neuroimaging methods, CT and MRI are able to diagnose early stroke and its complications – the authors present typical neuroradiological signs for cerebral ischaemia. Hyperdense middle cerebral artery sign (HMCAS), hypoattenuation of lentiform nucleus (ALN), loss of insular ribbon (LIR), hemispheric sulcus effacement (HES) were found as early abnormalities. CT examinations continue to play a dominant role in the initial diagnosis of acute cerebral ischaemia. Signs of early ischaemia can be often detected within the first three hours after onset, in the hyperacute phase. CT is used in evaluation of recent symptoms in acute phase and proper selection of patients for thrombolysis with significant therapeutic results.