CT Angiography in Ischemic Stroke: Optimization and Accuracy

Stroke is the third leading cause of death after coronary heart disease and cancer. The clinical burden of stroke now exceeds that of coronary heart disease.1 Especially in the aging population stroke is a major disease. By the year 2020 the incidence of stroke in the Netherlands is expected to have increased to 2.5 per 1000 and the prevalence to 8.7 per 1000 for the whole population.2 Stroke is also the most common cause of disabilities in adults. Therefore not only the disease impact but also the healthcare impact of stroke is substantial.3 Stroke is defined as the clinical syndrome of rapid onset of focal or global cerebral deficit with a presumed vascular cause. Different pathological mechanisms can be responsible for a stroke: cerebral ischemia (≈80%), primary intracerebral hemorrhage (≈15%), and subarachnoid hemorrhage (≈5%). Ischemic stroke is confined to an area of the brain perfused by a specific artery and lasts longer than 24 hours or has led to death. Transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by focal brain or retinal ischemia, with clinical symptoms usually lasting less than 24 hours, and without evidence of acute infarction.

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