Radiologic evaluation of ischemic cerebrovascular syndromes with emphasis on computed tomography.

In patients with stroke syndromes, the extent and sequence of investigations are based upon clinical probabilities and take into account the age, general condition, and wishes of the patient. There is no doubt that the evaluation of such patients has been changed and improved by CT. The incidence of intraparenchymal bleeding is higher, but its mortality is lower than previously believed. The incidence of hemorrhagic infarction is probably not as great as previously suspected, but the hazards of anticoagulant therapy in a patient with a hemorrhagic infarct are easily obviated if a CT scan is obtained before anticoagulant therapy is started. The initial evaluation of the patient has been improved by CT, but in addition, following the course of the patient is easier by obtaining serial scans when satisfactory recovery does not take place or continue at the expected rate. Parenchymal changes such as hemorrhagic change, mass effect, or obstruction of the ventricular system can be detected early, and approached rationally.