CT Head Perfusion With IV Contrast CT head perfusion imaging may detect an underlying lesion not identified by other imaging modalities in some cases of late presenting with strokes and may identify additional at-risk regions of the brain. Specific instances arise in patients with complete extracranial internal carotid artery occlusion in whom CTP can be used to determine its hemodynamic effect [17]. However, selection of patients with carotid occlusion for revascularization based on hemodynamic compromise does not improve outcome [18]. CTP may be a reasonable examination in the secondary workup of late presenting strokes, but it is not generally a first-line test in this clinical context. CT Head With IV Contrast There is no relevant literature to support the use of contrast-enhanced CT of the head in the evaluation of ischemic stroke; in fact, contrast may obscure early complications such as hemorrhage. CT Head Without and With IV Contrast There is no relevant literature to support the use of CT of the head without and with IV contrast in the evaluation of ischemic stroke; in fact, contrast may obscure early complications such as hemorrhage. CT Head Without IV Contrast Noncontrast CT of the head is essential in the initial evaluation of delayed presenting strokes to evaluate for complications such as hemorrhagic conversion, mass effect, and herniation. Moreover, noncontrast CT is more sensitive for the evaluation of early ischemic changes in late presenting strokes than in the hyperacute setting [67]. Dual-energy CT may play a role in the setting of prior contrast administration for other studies or for prior EVT in evaluating for underlying hemorrhage [68].
Cerebrovascular Diseases Stroke and Stroke Related Conditions PCAs. CT Head Perfusion With IV Contrast CT head perfusion imaging may detect an underlying lesion not identified by other imaging modalities in some cases of late presenting with strokes and may identify additional at-risk regions of the brain. Specific instances arise in patients with complete extracranial internal carotid artery occlusion in whom CTP can be used to determine its hemodynamic effect [17]. However, selection of patients with carotid occlusion for revascularization based on hemodynamic compromise does not improve outcome [18]. CTP may be a reasonable examination in the secondary workup of late presenting strokes, but it is not generally a first-line test in this clinical context. CT Head With IV Contrast There is no relevant literature to support the use of contrast-enhanced CT of the head in the evaluation of ischemic stroke; in fact, contrast may obscure early complications such as hemorrhage. CT Head Without and With IV Contrast There is no relevant literature to support the use of CT of the head without and with IV contrast in the evaluation of ischemic stroke; in fact, contrast may obscure early complications such as hemorrhage. CT Head Without IV Contrast Noncontrast CT of the head is essential in the initial evaluation of delayed presenting strokes to evaluate for complications such as hemorrhagic conversion, mass effect, and herniation. Moreover, noncontrast CT is more sensitive for the evaluation of early ischemic changes in late presenting strokes than in the hyperacute setting [67]. Dual-energy CT may play a role in the setting of prior contrast administration for other studies or for prior EVT in evaluating for underlying hemorrhage [68].