The CT diagnosis of cerebral infarction in the early stage

From January 1985 through December 1987, 127 consecutive patients have undergone intraarterial enhanced CT (IACE) for early diagnosis of cerebral ischemic attacks. The common carotid artery (CCA) was punctured by a slender needle. The contrast medium was subsequently injected at 5 ml/11 sec. For the normal brain, the cerebral cortex, basal ganglia, thalamus, the deep veins, and arteries were well stained, but the white matter was only weakly stained. Internal carotid artery (IAC) occlusion could be diagnosed if the injected side cerebrum was not stained. If only the territories of the posterior cerebral artery and the anterior choroidal artery were stained, the occlusion site was found distal to these arteries. For 58 patients with early stage cerebral ischemia (within 12 hours after attack), ischemic areas or occluded arteries were detected in 44 patients (76%). None of the patients experienced complications of IACE. This method seems to be safe, simple, inexpensive, and useful in the early diagnosis of cerebral ischemic attacks, although it is of limited value in the diagnosis of traumatic lesions and cerebellar and pontine ischemic attacks, as well as in the measurement of blood flow volume. (Namekawa, K)