Archive for the ‘CCT’ Category

PDM Perfusion-Diffusion Mismatch

Freitag, 13. September 2019






Freitag, 13. September 2019


Atlantoaxiale Dislokation

Dienstag, 05. Dezember 2017





Vasokonstriktionssyndrom (RZVS)

Donnerstag, 28. September 2017

Das Reversible zerebrale Vasokonstriktionssyndrom (RZVS)




Dienstag, 04. Juli 2017

CT- Stroke:

  1. Blutung oder andere Diagnose
  2. Frühzeichen eines Infarktes(Hyperdenses Arterienzeichen,Hypodenses oder verwaschene Hirngewebe Kontur)
  3. Infarktgroesse (ASPECTS)
  4. Mittels CT-Angiographie kann Indikation zur CT-Endovask. Therapie geprüft werden auch bei Antikoagulation.
ASPECTS:                       M1 - M3 inferior______________________________(3)

                               M4 - M6 superior______________________________(3)

Extrapyramidal_________________N. caud/ Linsenkern/Capsula int./ Insel_______(4)

Score 10 normal, Score 0 am schlechtesten._______________________________Sum.(10)


CT-Endovask. Therapie: Innerhalb von 6 Std. (Leitlinien 2018: Bis zu 16-24 Std. nach Infarkt. Siehe unten (*))

  1. Kollateral Status + (CTA und 4D MIP) KM prox. u. dist. der Arterien Occlusion
  2. ASPECTS (8-10)
  3. Prox. intracran. Arterien Occlusion

CT-Perfusion Infarkt:  MTT erhoet, CBV erniedrigt (CBV bei Tumor nicht erniedrigt)





(*)What’s different from previous recommendations is that patients who are ineligible for intravenous (IV) tissue plasminogen activator (tPA) may now be selected for mechanical thrombectomy within 6 hours.


(*)This new recommendation is a level 1A. (28.01.2018)

In light of the new results from DEFUSE-3, and a second study called DAWN, published January 4 also in NEJM, the new guidelines recommend thrombectomy in eligible patients 6 to 16 hours after a stroke (another level 1A recommendation).

And on the basis of the DAWN results, the procedure is „reasonable“ in patients 16 to 24 hours after a stroke (level IIa-B-R).


IV alteplase or thrombolysis remains the cornerstone of stroke therapy,“ Dr Powers said at a media briefing. „Everyone who is eligible for this should get it, and it should not be delayed to determine if they’re eligible for another treatment.“ Innerhalb 4,5 Std. nach Stroke.


Mechanical thrombectomy and tPA „are not mutually exclusive,“ and patients can receive both interventions, he said.


Some patients who are not eligible for tPA — for example, those on blood thinners like warfarin — may still be eligible for mechanical thrombectomy, noted Dr Powers.






Conclusions—Swollen cerebral and cerebellar infarcts are critical conditions that warrant immediate, specialized
neurointensive care and often neurosurgical intervention. Decompressive craniectomy is a necessary option in many
patients. Selected patients may benefit greatly from such an approach, and although disabled, they may be functionally
independent. (Stroke. 2014;45:00-00.)






The Role of Imaging in Acute Ischemic Stroke



rtpaLyse (2)

Bestimmung des frühen Zeitintervalls:







Sinusthrombose CCT nativ Guidelines

Montag, 19. Juni 2017

Hohe Dichte Sinus sag. nativ CCT linearer venoeser Infarkt

Hohe Dichte Sinus sag. nativ CCT

Flow void Sinus links









Differenzierung Duraler Sinusvenenzysten und Thrombosen


He summarized the main highlights of the new guidelines as follows:

Diagnostic Recommendations

  • The diagnostic recommendations are based on the impact of diagnostic procedures on patient outcome and not on process indicators.
  • For the diagnosis of CVT, computed tomographic venography, magnetic resonance venography, or intra-arterial venography can be used because these techniques have similar accuracies.
  • Prothrombotic and cancer screening are not recommended as a routine.

Therapeutic Recommendations

  • All patients with acute CVT should be anticoagulated parentally, preferably with low-molecular-weight heparin (LMWH).
  • Patients with large hemisphere lesions with impending herniation should be offered decompressive surgery.
  • Seizure prophylaxis with anticonvulsants is indicated in patients who experience an acute symptomatic seizure and have a venous infarct or hemorrhage.
  • Non–vitamin K anticoagulants (novel oral anticoagulants) are not recommended, particularly in the acute phase, because of the limited experience and unknown safety.
  • No recommendations could be made regarding acute endovascular treatment because of the very low quality of available evidence, pending the publication of the final results of the TO-ACT trial, which was prematurely terminated for futility this year.
  •  Pregnancy is not contraindicated after CVT, and subcutaneous LMWH is suggested during pregnancy to prevent recurrent venous thrombotic events.


Montag, 05. September 2016

SOP Orale Antikoagulation_2016.compressed



Direkte orale Antikoagulanzien in der traumatologischen Notaufnahme:


Therapieversager bei LE unter NOAK Therapie wurden beschrieben, eigener Fall in der Erfahrung.

Nach Wechsel auf  Warfarin Besserung der Symptomatik und Auflösung der Thromben

im CT.



Freitag, 18. Dezember 2015


Gerinnungkaskade Throbophilie1 Throbophilie2


DWI-Flair mismatch bei Insult

Freitag, 05. September 2014

DWI-FLAIR mismatch for the identification of patients with acute ischaemic stroke within 4·5 h of symptom onset (PRE-FLAIR): a multicentre observational study


Patients with an acute ischaemic lesion detected with DWI but not with FLAIR imaging are likely to be within a time window for which thrombolysis is safe and effective. These findings lend support to the use of DWI-FLAIR mismatch for selection of patients in a future randomised trial of thrombolysis in patients with unknown time of symptom onset.

Sinus cavernosus Thrombose

Samstag, 30. August 2014




Zur Werkzeugleiste springen