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]. CTA Head With IV Contrast CTA of the head is a rapid means of evaluating the intracranial vasculature for underlying intracranial atherosclerosis and steno-occlusive diseases, although the clinical value of this information is controversial [22,23,69]. Identification of the underlying etiology in the absence of progressive symptoms is less time sensitive than with patients undergoing EVT evaluation. Moreover, similar information can be obtained from MRA of the head without the need for rapid triage and vascular diagnosis. CTA of the head may be indicated in unstable patients presenting with uncertainty or concern for progression of prior ischemic infarcts. CTA Neck With IV Contrast CTA of the neck is a rapid means of evaluating the extracranial vasculature underlying carotid stenosis and other steno-occlusive disease of the cervical vasculature, which is useful in the management of late presenting strokes. Current AHA guidelines recommend noninvasive imaging of the cervical carotid arteries for patients with minor stroke who are candidates for CEA or stenting, within 24 hours of hospitalization or 48 hours of onset due to the high early risk of recurrent stroke in patients with symptomatic carotid stenosis [12,13]. In the absence of bilateral disease, carotid Doppler is more accurate in evaluating the degree of carotid stenosis; CTA typically overestimates stenosis, particularly in the setting of dense carotid calcification [24]. In the setting of cryptogenic stroke, CTA may be helpful to diagnose unsuspected carotid webs or other features of unstable plaque [81,82]. Cerebrovascular Diseases-Stroke CTV Head With IV Contrast There is no relevant literature to support the use of CTV of the head in the evaluation of ischemic stroke in the absence of suspicion for CVT.
Cerebrovascular Diseases Stroke and Stroke Related Conditions PCAs. 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]. CTA Head With IV Contrast CTA of the head is a rapid means of evaluating the intracranial vasculature for underlying intracranial atherosclerosis and steno-occlusive diseases, although the clinical value of this information is controversial [22,23,69]. Identification of the underlying etiology in the absence of progressive symptoms is less time sensitive than with patients undergoing EVT evaluation. Moreover, similar information can be obtained from MRA of the head without the need for rapid triage and vascular diagnosis. CTA of the head may be indicated in unstable patients presenting with uncertainty or concern for progression of prior ischemic infarcts. CTA Neck With IV Contrast CTA of the neck is a rapid means of evaluating the extracranial vasculature underlying carotid stenosis and other steno-occlusive disease of the cervical vasculature, which is useful in the management of late presenting strokes. Current AHA guidelines recommend noninvasive imaging of the cervical carotid arteries for patients with minor stroke who are candidates for CEA or stenting, within 24 hours of hospitalization or 48 hours of onset due to the high early risk of recurrent stroke in patients with symptomatic carotid stenosis [12,13]. In the absence of bilateral disease, carotid Doppler is more accurate in evaluating the degree of carotid stenosis; CTA typically overestimates stenosis, particularly in the setting of dense carotid calcification [24]. In the setting of cryptogenic stroke, CTA may be helpful to diagnose unsuspected carotid webs or other features of unstable plaque [81,82]. Cerebrovascular Diseases-Stroke CTV Head With IV Contrast There is no relevant literature to support the use of CTV of the head in the evaluation of ischemic stroke in the absence of suspicion for CVT.