chapter  3
44 Pages

Neurology and Non-Traumatic Spinal Imaging

WithGareth Lewis, Hiten Patel, Sachin Modi, Shahid Hussain

The commonest clinical sign of stroke is a focal neurological deficit. The diagnosis of transient ischaemic attack is a retrospective one, defined as a reversible neurological deficit that resolves within 24 hours. Unenhanced computed tomography (CT) imaging and magnetic resonance imaging (MRI) are the main imaging modalities used in acute stroke management. CT imaging is readily available and is considered the initial modality of choice. Carotid artery dissection (CAD) is estimated to be an underlying cause in up to 25% of strokes in young and middle-aged patients and should always be considered in young patients presenting with acute onset neurological signs. Both computed tomography angiography and magnetic resonance angiography are sensitive and specific for CAD. Subarachnoid haemorrhage is defined as blood within the space between the pial and arachnoid membranes and is a neurosurgical emergency. Cerebral venous sinus thrombosis is a potentially life-threatening neurological emergency.