CT Head CT of the head is frequently the front-line imaging study for the assessment of a child with a suspected acute stroke. Although CT is less sensitive than MRI for the early depiction of acute ischemic infarction, the technique is rapid, usually does not require the child to be sedated, and can be useful in evaluating for hemorrhage or in excluding other treatable pathologies [16]. CTA Head CT angiography (CTA) can provide a useful assessment of intracranial vessels in arteriopathies and thromboembolic disease [17]. MRA Head MR angiography (MRA) can provide information on the intracranial vasculature and is particularly helpful in noninvasive assessment of arteriopathies [17]. MRA is susceptible to flow-related artifacts that may simulate regions of stenosis, especially in the setting of turbulence that may occur with anemia at vessel branch points [26]. MRI and MRA of the cervical vessels in cases of unexplained stroke should be considered, with attention paid to the time constraints of the window of therapeutic intervention [27]. MRA can be performed with IV contrast to improve vessel delineation, although contrast is not typically required to produce diagnostic imaging in acute stroke. CT Head Perfusion Perfusion CT in children is feasible but requires repetitive imaging of the brain [28]. MR Head Perfusion Perfusion-weighted MR can be performed with either dynamic susceptibility contrast administration or arterial spin-label techniques without IV contrast and can provide information on the adequacy of cerebral blood flow [17,19,29]. Perfusion MR is not necessary to proceed to emergent acute stroke thrombolysis. CT Head CT of the head is frequently the initial imaging study for the assessment of a child with a suspected acute stroke.
Cerebrovascular Disease Child PCAs. CT Head CT of the head is frequently the front-line imaging study for the assessment of a child with a suspected acute stroke. Although CT is less sensitive than MRI for the early depiction of acute ischemic infarction, the technique is rapid, usually does not require the child to be sedated, and can be useful in evaluating for hemorrhage or in excluding other treatable pathologies [16]. CTA Head CT angiography (CTA) can provide a useful assessment of intracranial vessels in arteriopathies and thromboembolic disease [17]. MRA Head MR angiography (MRA) can provide information on the intracranial vasculature and is particularly helpful in noninvasive assessment of arteriopathies [17]. MRA is susceptible to flow-related artifacts that may simulate regions of stenosis, especially in the setting of turbulence that may occur with anemia at vessel branch points [26]. MRI and MRA of the cervical vessels in cases of unexplained stroke should be considered, with attention paid to the time constraints of the window of therapeutic intervention [27]. MRA can be performed with IV contrast to improve vessel delineation, although contrast is not typically required to produce diagnostic imaging in acute stroke. CT Head Perfusion Perfusion CT in children is feasible but requires repetitive imaging of the brain [28]. MR Head Perfusion Perfusion-weighted MR can be performed with either dynamic susceptibility contrast administration or arterial spin-label techniques without IV contrast and can provide information on the adequacy of cerebral blood flow [17,19,29]. Perfusion MR is not necessary to proceed to emergent acute stroke thrombolysis. CT Head CT of the head is frequently the initial imaging study for the assessment of a child with a suspected acute stroke.