{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T03:37:54Z","timestamp":1787888274872,"version":"build-2784847793"},"reference-count":30,"publisher":"FapUNIFESP (SciELO)","issue":"6","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Radiol Bras"],"abstract":"<jats:p>Abstract  Objective: To evaluate the importance of computed tomography and computed tomography angiography (CTA) in stroke protocols, as well as their impact on endovascular treatment and on the determination of the etiology.  Materials and Methods Were evaluated 28 patients with acute\/hyperacute stroke in the anterior circulation who underwent intracranial and cervical CTA between April 2018 and August 2019. The parameters evaluated were the degree of stenosis, plaque characteristics, type of infarct, treatment, etiology, and the Alberta Stroke Program Early CT Score (ASPECTS).  Results: Of the 28 patients evaluated, 16 (57.1%) had an ASPECTS of 10 (the maximum score, indicative of normality). Four patients (14.3%) underwent thrombolytic treatment, and seven (25.0%) underwent mechanical thrombectomy. The etiology was atherosclerosis in 32.1% of the patients, cerebral small-vessel disease in 7.1%, cardioembolic in 7.1%, and undetermined in 53.6%. Regarding plaque, 17.9% of the patients presented stenosis \u2265 50%, 21.4% presented stable plaques, and 42.9% presented vulnerable plaques. Patients with a lower ASPECTS were more likely to have relevant stenosis and were more likely to have a total infarct.  Conclusion: In the evaluation of patients with acute\/hyperacute strokes, CTA provides important information, identifying occlusion, as well as helping define the etiology and inform decisions regarding treatment.<\/jats:p>","DOI":"10.1590\/0100-3984.2020.0168","type":"journal-article","created":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T13:10:10Z","timestamp":1674825010000},"page":"360-366","source":"Crossref","is-referenced-by-count":5,"title":["Importance of computed tomography angiography in acute\/hyperacute ischemic stroke"],"prefix":"10.1590","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7737-8031","authenticated-orcid":false,"given":"Bruna Arrais","family":"Dias","sequence":"first","affiliation":[{"name":"Hospital Santa Marta (HSM),  Brazil; Hospital Universit\u00e1rio de Bras\u00edlia,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3046-8494","authenticated-orcid":false,"given":"Karenn Barros","family":"Bezerra","sequence":"additional","affiliation":[{"name":"Hospital Santa Marta (HSM),  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6385-2954","authenticated-orcid":false,"given":"Alexandre S\u00e9rgio de Ara\u00fajo","family":"Bezerra","sequence":"additional","affiliation":[{"name":"Hospital Santa Marta (HSM),  Brazil; Hospital Universit\u00e1rio de Bras\u00edlia,  Brazil; Universidade de Bras\u00edlia (UnB),  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4539-283X","authenticated-orcid":false,"given":"Vanessa Garcia","family":"Santana","sequence":"additional","affiliation":[{"name":"Hospital Santa Marta (HSM),  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9734-5157","authenticated-orcid":false,"given":"Raquel Rodrigues","family":"Borges","sequence":"additional","affiliation":[{"name":"Hospital Santa Marta (HSM),  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0290-8963","authenticated-orcid":false,"given":"Juliana Cavalcanti de Freitas","family":"Reinaux","sequence":"additional","affiliation":[{"name":"Hospital Santa Marta (HSM),  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6783-4523","authenticated-orcid":false,"given":"Daniel Lima","family":"Souza","sequence":"additional","affiliation":[{"name":"Hospital Santa Marta (HSM),  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2791-2109","authenticated-orcid":false,"given":"Fernando Bisinoto","family":"Maluf","sequence":"additional","affiliation":[{"name":"Hospital Santa Marta (HSM),  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2021,12]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"654980","DOI":"10.1155\/2014\/654980","article-title":"Detection of early ischemic changes in noncontrast CT head improved with \u201cstroke windows\u201d","volume":"2014","author":"Mainali S","year":"2014","journal-title":"ISRN Neurosci"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"2472","DOI":"10.1161\/01.STR.0000145330.14928.2a","article-title":"ASPECTS on CTA source images versus unenhanced CT: added value in predicting final infarct extent and clinical outcome","volume":"35","author":"Coutts SB","year":"2004","journal-title":"Stroke"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.3174\/ajnr.A1723","article-title":"CT angiography source images predict final infarct extent in patients with basilar artery occlusion","volume":"30","author":"Puetz V","year":"2009","journal-title":"AJNR Am J Neuroradiol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"245","DOI":"10.3389\/fneur.2016.00245","article-title":"A critical review of Alberta Stroke Program Early CT Score for evaluation of acute stroke imaging","volume":"7","author":"Schr\u00f6der J","year":"2017","journal-title":"Front Neurol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/1471-2377-14-37","article-title":"Prediction of outcome in patients with suspected acute ischaemic stroke with CT perfusion and CT angiography: the Dutch acute stroke trial (DUST) study protocol","volume":"14","author":"van Seeters T","year":"2014","journal-title":"BMC Neurol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1136\/neurintsurg-2018-014640","article-title":"Indications for thrombectomy in acute ischemic stroke from emergent large vessel occlusion (ELVO): report of the SNIS Standards and Guidelines Committee","volume":"11","author":"Mokin M","year":"2019","journal-title":"J Neurointerv Surg"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1161\/STROKEAHA.113.004260","article-title":"Impact of pretreatment noncontrast CT Alberta Stroke Program Early CT Score on clinical outcome after intra-arterial stroke therapy","volume":"45","author":"Yoo AJ","year":"2014","journal-title":"Stroke"},{"key":"ref8","first-page":"1670","article-title":"Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy","volume":"355","author":"Barber PA","year":"2000","journal-title":"ASPECTS Study Group. 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Stroke"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1590\/0004-282X20150034","article-title":"Multidetector computed tomography angiography in clinically suspected hyperacute ischemic stroke in the anterior circulation: an etiological workup in a cohort of Brazilian patients","volume":"73","author":"Pacheco FT","year":"2015","journal-title":"Arq Neuropsiquiatr"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.clineuro.2017.05.019","article-title":"Etiologic classification of ischemic stroke: where do we stand?","volume":"159","author":"Radu RA","year":"2017","journal-title":"Clin Neurol Neurosurg"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"2592","DOI":"10.1161\/STROKEAHA.107.484584","article-title":"South Asian patients with ischemic stroke: intracranial large arteries are the predominant site of disease","volume":"38","author":"Silva DA","year":"2007","journal-title":"Stroke"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"2143","DOI":"10.1161\/STROKEAHA.111.613752","article-title":"Oxfordshire community stroke project classification poorly differentiates small cortical and subcortical infarcts","volume":"42","author":"Asdaghi N","year":"2011","journal-title":"Stroke"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1148\/radiology.219.1.r01ap0695","article-title":"Early prediction of irreversible brain damage after ischemic stroke at CT","volume":"219","author":"von Kummer R","year":"2001","journal-title":"Radiology"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1007\/s00270-013-0711-2","article-title":"Imaging of the carotid artery vulnerable plaque","volume":"37","author":"Saba L","year":"2014","journal-title":"Cardiovasc Intervent Radiol"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1007\/s00234-007-0244-y","article-title":"Multidetector-row CT angiography in the study of atherosclerotic carotid arteries","volume":"49","author":"Saba L","year":"2007","journal-title":"Neuroradiology"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1590\/S0004-282X2012000600014","article-title":"Ischemic stroke in young adults: an overview of etiological aspects","volume":"70","author":"Yamamoto FI","year":"2012","journal-title":"Arq Neuropsiquiatr"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1159\/000210432","article-title":"Classification of stroke subtypes","volume":"27","author":"Amarenco P","year":"2009","journal-title":"Cerebrovasc Dis"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2147\/VHRM.S53203","article-title":"Strokes in young adults: epidemiology and prevention","volume":"11","author":"Smajlovic D","year":"2015","journal-title":"Vasc Health Risk Manag"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"213","DOI":"10.24950\/rspmi\/revisao\/200\/3\/2018","article-title":"Investiga\u00e7\u00e3o etiol\u00f3gica do acidente vascular cerebral no adulto jovem","volume":"25","author":"Correia JP","year":"2018","journal-title":"Medicina Interna"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1212\/WNL.0b013e318270401d","article-title":"Age at stroke: temporal trends in stroke incidence in a large, biracial population","volume":"79","author":"Kissela BM","year":"2012","journal-title":"Neurology"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"e005090","DOI":"10.1161\/JAHA.116.005090","article-title":"Age-specific vascular risk factor profiles according to stroke subtype","volume":"6","author":"Hauer AJ","year":"2017","journal-title":"J Am Heart Assoc"}],"container-title":["Radiologia Brasileira"],"original-title":["Import\u00e2ncia da angiotomografia computadorizada no acidente vascular encef\u00e1lico isqu\u00eamico agudo\/hiperagudo"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0100-39842021000600360&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T13:10:31Z","timestamp":1674825031000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0100-39842021000600360&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":30,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["S0100-39842021000600360"],"URL":"https:\/\/doi.org\/10.1590\/0100-3984.2020.0168","relation":{},"ISSN":["1678-7099"],"issn-type":[{"value":"1678-7099","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]}}}