Revista de neurologia · 2002
[Emergency CAT in stroke-why?].
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Morera-Guitart J, Más G
Аннотация
INTRODUCTION: A stroke is considered to be a neurological emergency, and it is recommended that an immediate CAT scan should be done in all patients. However, its usefulness may be controversial in the early stages.
OBJECTIVE: To show the diagnostic usefulness of early CAT scans following strokes.
PATIENTS AND METHODS: We made a retrospective study of a random sample of the requests for cranial CAT scans in suspected cerebrovascular disease between October 1998 and April 2000. We analyzed the diagnostic and therapeutic variations before and after CAT scans (pre CAT and post CAT moments).
RESULTS: We selected 210 cases. Average age: 72 10.4 (57% males). There was no difference in CAT findings (normal or vascular) related to the day it was done. Pre CAT diagnosis: non specific, 39.3%; intracranial haemorrhage (ICH), 17%. Post CAT diagnosis: the commonest was thrombotic infarct (23.7%), followed by non vascular , 20%. Pre CAT treatment: no treatment 47.9%; antiaggregant 30.4%; low molecular weight heparin 7.4%. Post CAT treatment: no treatment 17%, 21.7% of the patients with ICH received antiaggregants or anticoagulants prior to cranial CAT. Hemiplegia was more often associated with a vascular CAT scan whilst isolated dysarthria was with a normal CAT scan. Nineteen patients died and all of these had vascular CAT scans. The patients with vascular CAT scans were more often admitted to hospital.
CONCLUSIONS: The findings of cranial CAT scans during the acute stage of strokes are unpredictable. Early CAT scans in stroke patients permits improved diagnosis and treatment of patients, avoids serious errors of treatment and affects the outcome.
OBJECTIVE: To show the diagnostic usefulness of early CAT scans following strokes.
PATIENTS AND METHODS: We made a retrospective study of a random sample of the requests for cranial CAT scans in suspected cerebrovascular disease between October 1998 and April 2000. We analyzed the diagnostic and therapeutic variations before and after CAT scans (pre CAT and post CAT moments).
RESULTS: We selected 210 cases. Average age: 72 10.4 (57% males). There was no difference in CAT findings (normal or vascular) related to the day it was done. Pre CAT diagnosis: non specific, 39.3%; intracranial haemorrhage (ICH), 17%. Post CAT diagnosis: the commonest was thrombotic infarct (23.7%), followed by non vascular , 20%. Pre CAT treatment: no treatment 47.9%; antiaggregant 30.4%; low molecular weight heparin 7.4%. Post CAT treatment: no treatment 17%, 21.7% of the patients with ICH received antiaggregants or anticoagulants prior to cranial CAT. Hemiplegia was more often associated with a vascular CAT scan whilst isolated dysarthria was with a normal CAT scan. Nineteen patients died and all of these had vascular CAT scans. The patients with vascular CAT scans were more often admitted to hospital.
CONCLUSIONS: The findings of cranial CAT scans during the acute stage of strokes are unpredictable. Early CAT scans in stroke patients permits improved diagnosis and treatment of patients, avoids serious errors of treatment and affects the outcome.