The Alberta Stroke Program Early CT Score (ASPECTS) may help in a semiquantitative assessment of acute ischemia. The non-contrast CT scan may also show the "hyperdense" artery sign that provides some clues to the location of occlusion and clot burden. CT scan can also provide some information regarding the extent and severity of ischemic injury by enabling visualization of early ischemic changes that can be apparent "very early" after the onset of an acute stroke. A non-contrast-enhanced computed tomography (CT) of brain remains the current standard imaging study in acute stroke to differentiate a hemorrhagic from an ischemic event. In addition to a rapid clinical examination, several diagnostic tests are employed in the evaluation of ischemic stroke. Fast dissolution of the thrombi, and arterial recanalization in acute stroke, often leads to dramatic clinical recovery.
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Intravenously administered tissue plasminogen activator (TPA) induces thrombolysis and remains the only FDA-approved thrombolytic agent for use in ischemic stroke within 3 h from symptom onset.
Most patients presenting with an acute ischemic stroke have arterial thrombi occluding extracranial and/or intracranial arteries. Acute ischemic stroke results in focal neurological deficits referable to a particular cerebral arterial territory and usually manifests with weakness affecting one side of the body, speech impairment, visual disturbances, and a variety of other neurological symptoms.
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