Moreover, the extent of ischemic changes seen on noncontrast CT, regardless of chronicity, is correlated with the risk of subsequent strokes [21]. Cerebrovascular Diseases-Stroke CTA Head With IV Contrast CTA of the head is a rapid means of evaluating the intracranial vasculature for underlying intracranial atherosclerosis and other intracranial steno-occlusive diseases, which may be useful in the secondary workup and triage of patients presenting with TIA. The identification of atherosclerotic intracranial vascular lesions in the setting of TIA may be useful in determining the most appropriate treatment options, although this is controversial [22,23]. CTA Neck With IV Contrast CTA of the neck is a rapid means of evaluating the extracranial vasculature and is useful in the initial workup and triage of patients presenting with carotid territory TIA. Current American Heart Association (AHA) guidelines recommend noninvasive imaging of the cervical carotid arteries for patients with TIA or minor stroke who are candidates for CEA or stenting within 48 hours of onset [12]. Heavy calcifications or calcified plaque on both sides of the lumen can lead to overestimation of the stenosis [24]. CTV Head With IV Contrast There is no relevant literature to support the use of CT venography (CTV) head in the evaluation of TIA in the absence of suspicion for cerebral venous thrombosis (CVT). Please see Variant 7 for further details. MRA Head Without and With IV Contrast There is no relevant literature to support the use of contrast-enhanced MR angiography (MRA) of the head in the evaluation of TIA. MRA Head Without IV Contrast MRA of the head is an alternative means of evaluating intracranial steno-occlusive disease and may be useful in the initial workup and triage of patients presenting with TIA.
Cerebrovascular Diseases Stroke and Stroke Related Conditions PCAs. Moreover, the extent of ischemic changes seen on noncontrast CT, regardless of chronicity, is correlated with the risk of subsequent strokes [21]. Cerebrovascular Diseases-Stroke CTA Head With IV Contrast CTA of the head is a rapid means of evaluating the intracranial vasculature for underlying intracranial atherosclerosis and other intracranial steno-occlusive diseases, which may be useful in the secondary workup and triage of patients presenting with TIA. The identification of atherosclerotic intracranial vascular lesions in the setting of TIA may be useful in determining the most appropriate treatment options, although this is controversial [22,23]. CTA Neck With IV Contrast CTA of the neck is a rapid means of evaluating the extracranial vasculature and is useful in the initial workup and triage of patients presenting with carotid territory TIA. Current American Heart Association (AHA) guidelines recommend noninvasive imaging of the cervical carotid arteries for patients with TIA or minor stroke who are candidates for CEA or stenting within 48 hours of onset [12]. Heavy calcifications or calcified plaque on both sides of the lumen can lead to overestimation of the stenosis [24]. CTV Head With IV Contrast There is no relevant literature to support the use of CT venography (CTV) head in the evaluation of TIA in the absence of suspicion for cerebral venous thrombosis (CVT). Please see Variant 7 for further details. MRA Head Without and With IV Contrast There is no relevant literature to support the use of contrast-enhanced MR angiography (MRA) of the head in the evaluation of TIA. MRA Head Without IV Contrast MRA of the head is an alternative means of evaluating intracranial steno-occlusive disease and may be useful in the initial workup and triage of patients presenting with TIA.