Hyperacute Transcapillary Stroke - MR T2 or FLAIR
Hyperacute Transcapillary Stroke - MR T2 or FLAIR
Search Pattern Assist ?History
Exam
Purpose
2 Use T2/FLAIR sequence to confirm edema in a recognizable terminal artery ischemic arterial zone or zones.
3 Use T2/FLAIR sequence to confirm edema in a recognizable dural sinus thrombosis zone or zones.
4 Use T2/FLAIR sequence to confirm edema in a recognizable cortical vein egress zone or zones.
5 Use T2/FLAIR to assess blood flow within the major dural sinuses (delta or empty delta signs) or major pial veins.
6 Use FLAIR to estimate the most likely stroke-age and/or depth of the ischemic injury based on the conspicuity of the FLAIR compared to the DWI sequences.
7 Use FLAIR to detect signal change and increased size of retrograde, collateral pial artery filling.
8 Use FLAIR to detect protein leak in the CSF spaces.
9 Use T2/FLAIR to detect PRES.
10 Use T2/FLAIR to detect focal mass effect, hydrocephalus, optic hydrops, or impending herniation of brain.
11 Use turbo spin-echo coronal T2-w to assess for acute seizure event affecting one or both hippocampi.
Prior Study
Findings
MR T2-w or Flair
There is prominence of the Virchow-Robin spaces surrounding the cerebral perforatoring arteries or around the deep medullary veins, as often seen in the moyamoya vasculopathy. [Yes/No]
There is increased T2 or flair signal following the Virchow-Robin spaces surrounding the cerebral penetrating white matter arteries or around the deep medullary veins, as often seen CNS angiitis and CNS microembolization. [Yes/No]
There is minimally abnormal FLAIR in any site of positive diffusion imaging (implying stroke timeframe is recent (<6 hours). [Yes/No]
Given both the MR flair and the turbo spin-echo T2 are positive the ischemic event is beyond 8 hours. [Yes/No]
There is positive FLAIR in an arterial or dural sinus wall or lumen indicating the presence of residual acute thrombus. [Yes/No]
Assess the T2 MR for optic hydrops (often requires multiplanar reformations). [Yes/No]
There is evidence of early brain swelling or hemorrhage sufficient to produce evidence of brain shift and/or herniation. [Yes/No]
There is evidence of early subependymal edema plus mild venticulomegaly indicating early stage of hydrocephalus. [Yes/No]
Other
No other abnormalities are noted. [Yes/No]
