Images and videos

Images

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1

Ischaemic stroke

Non-contrast CT scan of brain showing sub-acute isolated left basal ganglion infarction with left frontal horn mass effect

Courtesy of BMJ Case Reports 2009; doi:10.1136/bcr.10.2008.1139

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3

Ischaemic stroke

(A) Perfusion CT (time to peak (TTP) map) of acute left MCA ischaemia sub-three hours and (B) equivalent non-contrast CT. Perfusion CT predicts final infarct volume in the absence of arterial recanalisation: (C) three hour TTP map and (D) 24 hour non-contrast CT

Muir KW et al. Neuro 2005; 76: iii19-iii28; used with permission

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2

Ischaemic stroke

Two examples of early ischaemic changes on CT in sub-three hour ischaemic stroke. (A) Acute left middle cerebral artery (MCA) ischaemia with loss of insular ribbon, and hypodensity of tail of lentiform nucleus. (B) Similar changes in a different patient, with hypodensity of entire lentiform nucleus, some hemispheric sulcal effacement, and compression of lateral ventricle caused by hypodensity of caudate head

​Muir KW et al. Neurology, Neurosurgery & Psychiatry 2005; 76: iii19-iii28; used with permission

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6

Ischaemic stroke

MRI arterial spin labelling image showing extensive hypoperfusion in the right cerebral hemisphere. There is a clear mismatch between diffusion and perfusion

From the personal collection of Eric E. Smith; used with permission

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4

Ischaemic stroke

Apparent diffusion coefficient (ADC) map and diffusion weighted MRI (DWI) of subacute stroke (day 3). Restricted diffusion of water leads to decreased signal on ADC, increased signal on DWI

Muir KW et al. Neuro 2005; 76: iii19-iii28; used with permission

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5

Ischaemic stroke

(A) Non-contrast T1-weighted MRI. (B) Post-contrast T1-weighted MRI showing minimal increase in leptomeningeal vessels over the right frontal region. (C) Diffusion-weighted image (DWI) showing a hyperintense area in the right frontal region. (D) Apparent diffusion coefficient (ADC) map shows hypointense lesion, indicating restricted diffusion that correlates with high intensity on DWI and exponential diffusion. (E) ADC value is 0.22 x 10³ mm²/second, corresponding to a hyperacute infarct

From the personal collection of Eric E. Smith; used with permission

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