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Chapter 4 - Stroke Radiology

Published online by Cambridge University Press:  28 October 2019

Mary Carter Denny
Affiliation:
Georgetown University Hospital
Ahmad Riad Ramadan
Affiliation:
Henry Ford Hospital, Detroit
Sean I. Savitz
Affiliation:
University of Texas Health Science Center, Houston
James Grotta
Affiliation:
Memorial Hermann Texas Medical School
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Summary

Non-contrast CT (NCCT) of the head remains the standard procedure for the initial evaluation of stroke.

In the emergent initial evaluation of an acute stroke patient in the emergency department, NCCT remains the imaging modality utilized in most hospitals worldwide, with the exception of a few centers that have dedicated MRI capabilities for stroke. NCCT has the advantages of being widely available, relatively inexpensive, and fast to perform, but the disadvantages of radiation exposure and not being able to exclude stroke mimics such as complicated migraine and peripheral vertigo, as compared to MRI. The clinical presentation of a patient with an intracerebral hemorrhage can be indistinguishable from that of an ischemic stroke.

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