A Change of Heart: Yield of Cardiac Imaging in Acute Stroke Workup

Figures

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  Fig. 1.. Head computed tomography (CT) images of the patient at admission and at follow-up. Top row with admission imaging of a non-contrast CT with early signs of ischemic stroke (red oval), b CT angiography (CTA) with occlusion (white arrow) of the proximal middle cerebral artery, c and CT perfusion (CTP) showing perfusion deficit in the territory of the right middle cerebral artery (red oval). Bottom row with follow-up imaging of d non-contrast CT with ischemic alterations in both hemispheres (red and blue ovals), e follow-up CTA without a visible occlusion, f and CTP showing a new perfusion deficit in the left parietal region (blue oval).

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  Fig. 2.. Cardiac dual-energy computed tomography (CT) angiography images of the patient at admission and at follow-up. CTA with a two-chamber view of the left ventricle at admission (top row) and follow-up after stroke recurrence (bottom row). Admission CTA with a conventional (120 kV), b 40 keV, and c iodine setting showing 2 thrombi, 1 in the left atrial appendage (white arrow) and 1 in the left ventricle (black arrow). Follow-up CTA with d conventional (120 kV), e 40 keV, and f iodine setting showing diminution of the ventricular thrombus (black arrow) and the unaltered left atrial appendage thrombus (white arrow).