The middle cerebral artery density and ratio for the diagnosis of acute ischaemic stroke in the Emergency Department

Abstract

Acute stroke is one of the leading causes of death and adult disability, with haemorrhagic and ischaemic variants. 1 Neuroradiological examinations have been the cornerstone of the diagnosis of both ischaemic and haemorrhagic stroke. Non-contrast computed tomography (ncCT) is often the primary, inexpensive, fast and most available imaging modality for patients with clinical symptoms of acute stroke and haemorrhagic stroke may be diagnosed instantly in most cases. 2 However, the diagnosis of acute ischaemic stroke (AIS) is a bit more challenging.Radiological findings of AIS on ncCT are subtle and complex to recognise compared with haemorrhagic stroke. Therefore, early ischaemic changes (EICs) on ncCT have been systematically reviewed. 3 The middle cerebral artery (MCA) occlusion is the most common and debilitating form of AIS. Early detection and intervention have a significant prognostic value as the MCA infarction is related to poor outcomes and increased mortality. 4 Therefore, newer technologies and techniques to identify the occlusion of MCA or other arteries have been developed.According to the recent guidelines, ncCT and computed tomography angiogram (CTA) are the most recommended, practical and feasible

Supra‐Blan2t score as a multisystem‐based risk score to predict poor 3‐month outcome in acute ischemic stroke patients with intravenous thrombolysis

“…cohort of 333 patients. 9 In the DRAGON score, the radiological recognition of (hyper) dense cerebral artery sign or early infarct sign upon admission using brain CT was subtle and complex owing to the huge subjectivity and limited imaging experience of neurologists, 26,27 making it difficult to implement in grassroots medical and health service systems in China. Asuzu et al 28 This study also had several limitations.…”

“…For example, Strbian et al created the DRAGON score composed of the imaging parameter of CT head scan, prestroke mRS score, age, admission blood sugar level, onset‐time to treatment, and admission NIHSS score to validate its predictive power in a validation cohort of 333 patients. 9 In the DRAGON score, the radiological recognition of (hyper) dense cerebral artery sign or early infarct sign upon admission using brain CT was subtle and complex owing to the huge subjectivity and limited imaging experience of neurologists, 26 , 27 making it difficult to implement in grassroots medical and health service systems in China. Asuzu et al 28 calculated the TURN score for each patient in a multicenter cohort as follows: TURN = −4.65 + (prestroke mRS × 0.27) + (admission NIHSS score × 0.10).…”