Institutions using CT Stroke Protocol

[Dasani0127]

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Hey all -

I am trying to get a list of institutions that use the CT stroke Protocol since I realize not everyone is using them. Please list all of the places you KNOW to be using the CTSP. Thanks guys!

 

[typhoonegator]

I think that if you want an accurate list of replies, you'll need to tell us what is included in your concept of a "CT stroke protocol". Is it CT/CTA/CTP with slab reformats? Does the CT have to scan through the heart, or are the great vessels enough? Does this all have to be done within a certain time from the door? Are you referring to the AJNR paper from 2003 (Wade Smith et al)?

 

[neuroir]

since I realize not everyone is using them.

Is there a compelling reason for everyone to be using "CT stroke protocol"? If so, please enlighten us. I always thought this is a matter of personal preference and equipment availability. In any event, to answer your question: of those I am aware of, UCSF, Minnesota, and Cincinnati, use CT/CTA/CT perfusion, whereas UCLA and Stanford use MRI/MRA/MR perfusion.

 

[typhoonegator]

MGH usually does CT/CTA/CTP if a case looks clearly neurointerventional. But if the next step is less clear, they often just get CT/CTA, and then go straight to STAT MRI for DWI and MR-perfusion to more clearly define any diffusion/perfusion mismatch.

I have no idea if this is written down on some "CT stroke protocol", but that is generally how it is done.

 

[Strokeguy]

Houston, Columbia and Pittsburgh also use a CT/CTA/CT perfusion. With regards to CTA it is important to include the aortic arch, provides valuable info regarding carotid and vert origins. Also you can look at the arch for things like bovine origin of carotids or verts arising directly from the arch. This also gives info to the interventionalist before IA. Sometimes both verts arise from 'one subclavian'. I have also seen big calcified plaques in the arch with overlying thrombus which broke off and caused the stroke (helps establish etiology).