Computerised tomography in the investigation of stroke

CT's are attractive on account of their simplicity to perform, rapidity, largely non-invasive nature, low cost and ability to distinguish ischaemia and haemorrhage.

Disadvantages in the assessment of ischaemic stroke:

• the full extent of infarcted tissue cannot be defined until several days afterwards
• CT scans are best done promptly, preferably within 48 hrs of, and no later than 7 days after, the onset of symptoms (1)
• there may be a period of isodensity at day 3
• repeat scans are essential to determine prognosis
• visualisation may be assisted using contrast media but at the increased complexity and risk
• the brainstem structures are poorly displayed because of bony artifacts

Disadvantage in the assessment of haemorrhage:

• difficult to distinguish primary cerebral haemorrhage from confluent haemorrhagic infarction

Reference:

• 1. Drug and Therapeutics Bulletin 1998; 36 (7): 51-6.