3  Stroke Fast Track

🎯 Time: CT to Short Prelim Report ≤ 20 min

Goal
  • ICH ?
  • ASPECT Score: If onset < 24 hr or Unknown onset
  • Location of prior infarction ? (if presented)
  • Arterial occlusion ? (Site ?, Thrombus lenght ?)

3.2 Guildline

Figure 3.1: Acute Stroke Imaging Guideline [1]

3.3 ASPECT

3.4 Stroke CT Template

EMERGENCY MDCT OF THE BRAIN (Stroke Fast Track)

HISTORY: [stroke onset] [symptoms and signs]

TECHNIQUES: Axial conventional scan of the brain with 4-mm slice thickness

  • Intravenous contrast brand, concentration, volume: Not used.
  • Immediate complication: None.
  • Estimated radiation dose: 🤔 mGy, 🤔 mGycm.

(Standard DRL recommended by the American College of Radiology and European Commission = 75 mGy, 1050 mGycm. Values reported for 16-32-cm PMMA phantom. Uncertainties associated with this method are approximately 20%.)

COMPARISON: None.

FINDINGS:

  • Cerebral parenchyma: Normal.

  • Alberta Stroke Program Early CT score (ASPECTS): 🤔/10 or N/A.

[insert number in case of suspected MCA stroke with ONSET < 24 hours or WAKE-UP strokes (= unknown stroke onset), otherwise use N/A]

  • Cerebellum and posterior fossa: Normal given a limited evaluation of the brainstem due to beam-hardening artifacts.

  • Posterior-fossa ASPECTS: 🤔/10 or N/A.

[insert number in case of suspected MCA stroke with ONSET < 24 hours or WAKE-UP strokes (= unknown stroke onset), otherwise use N/A]

  • Extraaxial spaces: Appropriate for age.
  • Ventricles: Appropriate for age.
  • Midline shift: None.
  • Brain herniation: None.
  • Vascular system: Normal.
  • Calvarium and scalp: Normal.
  • Skull base, sella and temporomandibular joints (TMJs): Normal.
  • Visualized orbits, paranasal sinuses and mastoid air cells: Normal.
  • Visualized upper cervical spine: No fracture identified.

IMPRESSION:

  • This is a PRELIMINARY report made by radiology physician trainees. It has not been reviewed by the attending radiologist.

  • This is a PRELIMINARY report made by radiology physician trainees. The study has been REVIEWED by the attending radiologist but the report is not yet finalized.

  • No intracranial hemorrhage, extra-axial collection, acute large territorial infarction, midline shift or brain herniation identified.

Door datetime: xx/xx/20xx xx:xx [ER Check in time, seen in V/S page in EMR].

CT datetime: xx/xx/20xx xx:xx xx:xx [Time of the first image of plain CT].