EMCritRACC
EMCritRACC - August 28, 2018 - By Ashley Mogul
"The Question
We know that non-contrast head cts fail us in the evaluation of posterior strokes, but can posterior circulation stroke (without posterior large vessel occlusion) be diagnosed with CT perfusion (CTP) in lieu of MRI?
The Answer
Based on current literature and discussions with some experts in the field, the answer seems to be no. MRI remains the gold standard for the diagnosis of stroke in general. But if you pose the question a different way the answer becomes more interesting: is CTP useful in early diagnosis of posterior stroke? Classically we are taught that the posterior fossa is difficult to appreciate on CT due to artifact from the skull base, but with improved resolution and adjunctive studies like CT angiogram (CTA) and CTP is this still true?..."