Packard Andreja S, Kase Carlos S, Aly Ahmed S, Barest Glenn D
Department of Neurology, Boston University Medical Center, 715 Albany Street B-605, Boston, MA 02118, USA.
Arch Neurol. 2003 Aug;60(8):1156-9. doi: 10.1001/archneur.60.8.1156.
Noncontrast computed tomographic (CT) scanning of the brain is the main imaging modality recommended for the initial emergency evaluation of acute stroke. The main role of CT in this setting is to rule out intracerebral hemorrhage, especially in subjects who are potential candidates for thrombolytic therapy.
We studied a patient who had symptoms suggestive of a transient ischemic attack. Although serial CT scans showed no evidence of hemorrhage, a subacute intracerebral hemorrhage was demonstrated by magnetic resonance imaging.
This case suggests that an alternative to CT scanning should be considered in patients with acute stroke to lower the risk of an undetected intracerebral hemorrhage, especially in patients being considered for thrombolytic or anticoagulant therapy. There is evidence in the literature of other "CT-negative" cases of intracerebral hemorrhage, as well as the availability of alternative imaging techniques such as gradient echo ("susceptibility-weighted") magnetic resonance imaging sequences, which can enhance the ability of magnetic resonance imaging to detect an acute intracerebral hemorrhage.
脑部非增强计算机断层扫描（CT）是急性中风初始紧急评估推荐的主要成像方式。CT在这种情况下的主要作用是排除脑出血，特别是在可能接受溶栓治疗的患者中。
我们研究了一名有短暂性脑缺血发作症状的患者。尽管系列CT扫描未显示出血迹象，但磁共振成像显示为亚急性脑出血。
该病例表明，对于急性中风患者，应考虑采用CT扫描以外的方法以降低未检测到脑出血的风险，特别是在考虑进行溶栓或抗凝治疗的患者中。文献中有其他脑出血“CT阴性”病例的证据，以及如梯度回波（“敏感性加权”）磁共振成像序列等替代成像技术的可用性，这可以增强磁共振成像检测急性脑出血的能力。
