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Advanced CT for diagnosis of seizure-related stroke mimics

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Advanced CT for diagnosis of seizure-related stroke mimics. / Austein, Friederike; Huhndorf, Monika; Meyne, Johannes; Laufs, Helmut; Jansen, Olav; Lindner, Thomas.

In: EUR RADIOL, Vol. 28, No. 5, 05.2018, p. 1791-1800.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Austein, F, Huhndorf, M, Meyne, J, Laufs, H, Jansen, O & Lindner, T 2018, 'Advanced CT for diagnosis of seizure-related stroke mimics', EUR RADIOL, vol. 28, no. 5, pp. 1791-1800. https://doi.org/10.1007/s00330-017-5174-4

APA

Austein, F., Huhndorf, M., Meyne, J., Laufs, H., Jansen, O., & Lindner, T. (2018). Advanced CT for diagnosis of seizure-related stroke mimics. EUR RADIOL, 28(5), 1791-1800. https://doi.org/10.1007/s00330-017-5174-4

Vancouver

Austein F, Huhndorf M, Meyne J, Laufs H, Jansen O, Lindner T. Advanced CT for diagnosis of seizure-related stroke mimics. EUR RADIOL. 2018 May;28(5):1791-1800. https://doi.org/10.1007/s00330-017-5174-4

Bibtex

@article{e9865148f1b348748c476ac5ddfc5b06,
title = "Advanced CT for diagnosis of seizure-related stroke mimics",
abstract = "BACKGROUND AND PURPOSE: It is assumed that up to 30 % of clinically diagnosed acute ischaemic strokes (AIS) are actually stroke mimics (SM). Our aim was to evaluate the usefulness of advanced CT including CT angiography (CTA) and CT perfusion (CTP) findings when distinguishing AIS from seizure-related SM.METHODS: Over a 22-month period data were gathered of patients who presented to our stroke centre with AIS-like symptoms and were examined immediately with an advanced CT, analysed and evaluated by two experienced neuroradiologists who preferred SM rather than AIS. All these patients additionally received electroencephalography and follow-up imaging. CTA was the important feature to exclude vessel occlusion or haemodynamic relevant stenosis. Perfusion patterns were retrospectively analysed qualitatively.RESULTS: The most common perfusion abnormality was cortical hyperperfusion (22/37 [59.5 %] patients) followed by a hypoperfusion pattern with a cortical-subcortical involvement (15/37 [40.5 %] patients) without evidence of vessel occlusion or stenosis. Seizure-related hyper- and hypoperfusion patterns typically crossed the normal anatomical vascular territories boundaries.CONCLUSION: Beyond its use in core and penumbra estimation, advanced CT provides important information to emergency physicians in the difficult clinical diagnosis when differentiating between AIS and seizure-related symptoms with an important impact on therapeutic decision-making.KEY POINTS: • Advanced CT helps to differentiate between ischaemic strokes and stroke mimics. • Seizure-related perfusion patterns are distinct from ischaemia hypoperfusion. • Advanced CT could improve rapid adequate treatment for AIS and seizure events.",
keywords = "Aged, Aged, 80 and over, Brain/diagnostic imaging, Computed Tomography Angiography/methods, Diagnosis, Differential, Electroencephalography, Female, Humans, Magnetic Resonance Imaging/methods, Male, Multidetector Computed Tomography/methods, ROC Curve, Retrospective Studies, Seizures/complications, Stroke/diagnosis",
author = "Friederike Austein and Monika Huhndorf and Johannes Meyne and Helmut Laufs and Olav Jansen and Thomas Lindner",
year = "2018",
month = may,
doi = "10.1007/s00330-017-5174-4",
language = "English",
volume = "28",
pages = "1791--1800",
journal = "EUR RADIOL",
issn = "0938-7994",
publisher = "Springer",
number = "5",

}

RIS

TY - JOUR

T1 - Advanced CT for diagnosis of seizure-related stroke mimics

AU - Austein, Friederike

AU - Huhndorf, Monika

AU - Meyne, Johannes

AU - Laufs, Helmut

AU - Jansen, Olav

AU - Lindner, Thomas

PY - 2018/5

Y1 - 2018/5

N2 - BACKGROUND AND PURPOSE: It is assumed that up to 30 % of clinically diagnosed acute ischaemic strokes (AIS) are actually stroke mimics (SM). Our aim was to evaluate the usefulness of advanced CT including CT angiography (CTA) and CT perfusion (CTP) findings when distinguishing AIS from seizure-related SM.METHODS: Over a 22-month period data were gathered of patients who presented to our stroke centre with AIS-like symptoms and were examined immediately with an advanced CT, analysed and evaluated by two experienced neuroradiologists who preferred SM rather than AIS. All these patients additionally received electroencephalography and follow-up imaging. CTA was the important feature to exclude vessel occlusion or haemodynamic relevant stenosis. Perfusion patterns were retrospectively analysed qualitatively.RESULTS: The most common perfusion abnormality was cortical hyperperfusion (22/37 [59.5 %] patients) followed by a hypoperfusion pattern with a cortical-subcortical involvement (15/37 [40.5 %] patients) without evidence of vessel occlusion or stenosis. Seizure-related hyper- and hypoperfusion patterns typically crossed the normal anatomical vascular territories boundaries.CONCLUSION: Beyond its use in core and penumbra estimation, advanced CT provides important information to emergency physicians in the difficult clinical diagnosis when differentiating between AIS and seizure-related symptoms with an important impact on therapeutic decision-making.KEY POINTS: • Advanced CT helps to differentiate between ischaemic strokes and stroke mimics. • Seizure-related perfusion patterns are distinct from ischaemia hypoperfusion. • Advanced CT could improve rapid adequate treatment for AIS and seizure events.

AB - BACKGROUND AND PURPOSE: It is assumed that up to 30 % of clinically diagnosed acute ischaemic strokes (AIS) are actually stroke mimics (SM). Our aim was to evaluate the usefulness of advanced CT including CT angiography (CTA) and CT perfusion (CTP) findings when distinguishing AIS from seizure-related SM.METHODS: Over a 22-month period data were gathered of patients who presented to our stroke centre with AIS-like symptoms and were examined immediately with an advanced CT, analysed and evaluated by two experienced neuroradiologists who preferred SM rather than AIS. All these patients additionally received electroencephalography and follow-up imaging. CTA was the important feature to exclude vessel occlusion or haemodynamic relevant stenosis. Perfusion patterns were retrospectively analysed qualitatively.RESULTS: The most common perfusion abnormality was cortical hyperperfusion (22/37 [59.5 %] patients) followed by a hypoperfusion pattern with a cortical-subcortical involvement (15/37 [40.5 %] patients) without evidence of vessel occlusion or stenosis. Seizure-related hyper- and hypoperfusion patterns typically crossed the normal anatomical vascular territories boundaries.CONCLUSION: Beyond its use in core and penumbra estimation, advanced CT provides important information to emergency physicians in the difficult clinical diagnosis when differentiating between AIS and seizure-related symptoms with an important impact on therapeutic decision-making.KEY POINTS: • Advanced CT helps to differentiate between ischaemic strokes and stroke mimics. • Seizure-related perfusion patterns are distinct from ischaemia hypoperfusion. • Advanced CT could improve rapid adequate treatment for AIS and seizure events.

KW - Aged

KW - Aged, 80 and over

KW - Brain/diagnostic imaging

KW - Computed Tomography Angiography/methods

KW - Diagnosis, Differential

KW - Electroencephalography

KW - Female

KW - Humans

KW - Magnetic Resonance Imaging/methods

KW - Male

KW - Multidetector Computed Tomography/methods

KW - ROC Curve

KW - Retrospective Studies

KW - Seizures/complications

KW - Stroke/diagnosis

U2 - 10.1007/s00330-017-5174-4

DO - 10.1007/s00330-017-5174-4

M3 - SCORING: Journal article

C2 - 29218615

VL - 28

SP - 1791

EP - 1800

JO - EUR RADIOL

JF - EUR RADIOL

SN - 0938-7994

IS - 5

ER -