ASPECTS CT sọ não dấu hiệu đột quỵ sớm

Click icon to add picture Click icon to add picture Click icon to add picture ASPECTS in Hyperacute Ischemic Stroke Nguyễn Thanh Long Alberta stroke program early CT score (ASPECTS) • The Alberta stroke programme early CT score (ASPECTS) is a 10-point quantitative topographic CT scan score used in patients with middle cerebral artery stroke • It has also been adapted for the posterior circulation Scoring system Click icon to add picture Caudate Putamen Internal capsule Insular cortex M1: "anterior MCA cortex," corresponding to frontal operculum M2: "MCA cortex lateral to insular ribbon" corresponding to anterior temporal lobe M3: "posterior MCA cortex" corresponding to posterior temporal lobe M4: "anterior MCA territory immediately superior to M1" M5: "lateral MCA territory immediately superior to M2" M6: "posterior MCA territory immediately superior to M3" Important points Click icon to add picture The initial paper specifically referred to the internal capsule only involving the posterior limb, however, subsequent articles indicate any portion of the internal capsule may be included M1 to M3 are at the level of the basal ganglia M4 to M6 is at the level of the ventricles immediately above the basal ganglia Early signs on CT • Hyperdense segment of a vessel • Loss of grey-white matter differentiation • Hypoattenuation of deep nuclei • Cortical hypodensity with associated parenchymal swelling with resultant gyral effacement Polycythemia Click icon to add picture Click icon to add picture Hyperdense segment of a vessel Representing direct visualization of the intravascular thrombus / embolus and as such is visible immediately Click icon to add picture Click icon to add picture Click icon to add picture Click icon to add picture Loss of grey-white matter differentiation, and hypoattenuation of deep nuclei: lentiform nucleus changes seen as early as hour after occlusion, visible in 75% of patients at hours Cortical hypodensity with associated parenchymal swelling with resultant gyral effacement: cortex which has poor collateral supply (e.g insular ribbon) is more vulnerable Click icon to add pictur e Clinical use Cases for interpretation Case Code Hospital 18615682 115 people’s hospital 18616486 115 people’s hospital 18605791 115 people’s hospital 18603612 115 people’s hospital 17707812 115 people’s hospital 17708293 115 people’s hospital 18690122 Nghe An general hospital http://www.aspectsinstroke.com/ XIN TRÂN TRỌNG CẢM ƠN! ...Alberta stroke program early CT score (ASPECTS) • The Alberta stroke programme early CT score (ASPECTS) is a 10-point quantitative topographic CT scan score used in patients with middle... embolus and as such is visible immediately Click icon to add picture Click icon to add picture Click icon to add picture Click icon to add picture Loss of grey-white matter differentiation, and hypoattenuation... resultant gyral effacement Polycythemia Click icon to add picture Click icon to add picture Hyperdense segment of a vessel Representing direct visualization of the intravascular thrombus / embolus