| Abstract [eng] |
Acute ischaemic stroke is one of the most common causes of death and disability. It often presents unexpectedly and progresses rapidly, so timely diagnosis and appropriate individualised treatment are crucial to achieve the best survival and long-term functional independence outcomes. Several classifications of acute ischaemic stroke are used in clinical practice, but the most popular is the TOAST (Trail of Of 10172 in Acute Stroke Treatment) classification, which distinguishes 5 types of ischaemic stroke: large artery atherosclerotic, cardioembolic, small vessel (lacunar), other aetiologies, and unknown aetiologies (cryptogenic). Although the causes of ischaemic stroke may be different, the pathophysiological mechanisms leading to cell damage are similar. These lesions can be identified using radiological techniques. Computed tomography, with and without contrast material, is one of the main investigative techniques for the rapid and accurate diagnosis of ischaemic stroke. This method of investigation allows a comprehensive analysis of the location of the occlusion and the characteristics of the clot. Thrombus length, volume, density, CBS, permeability, histology and localisation are the parameters that can be determined. The standardised calculation of these parameters and the interpretation of the results provide a wealth of clinical information. In patients with acute ischaemic stroke, the radiological characteristics of the clot can be used to determine whether intravenous thrombolysis will be effective, whether mechanical thrombectomy will be effective in removing the clot on the first occasion, and what the risk of fragmentation of the clot is and of its further dislodgement. The radiological characteristics of the thrombus also allow us to predict the patient's disability and neurological status over time and possible aetiologies of the thrombus. Analysis of the occlusion site and clot characteristics by computed tomography provides valuable information in clinical practice and promotes individualised patient management and better outcomes. |
