Lesson 1Perfusion imaging interpretation: core vs penumbra, Tmax, CBF, CBV thresholds and pitfallsThis lesson breaks down CT and MR perfusion reading, spotting core from penumbra using CBF, CBV, and Tmax maps, common cut-off numbers, machine variations, glitches, and traps that might sway treatment choices.
Physiologic basis of core and penumbraTmax, CBF, and CBV map interpretationCommon numeric thresholds and caveatsArtifacts, motion, and truncation errorsChronic infarct and leukoaraiosis pitfallsLesson 2Guidelines and decision thresholds: major society recommendations for imaging selection and treatment windowsThis lesson sums up big guideline advice for acute stroke scans, time limits for clot-busters and clot removal, imaging picks beyond usual times, and applying cut-offs in daily practice.
Key AHA/ASA and ESO imaging guidanceImaging criteria for IV thrombolysisImaging criteria for thrombectomyLate-window and wake-up stroke imagingReconciling guidelines with local practiceLesson 3Communication with stroke team: phrasing for thrombolysis and thrombectomy eligibility, recommended next imaging and monitoringThis lesson covers short, punchy talks with the stroke team, standard words for clot-buster and clot removal suitability, doubt statements, next scans advised, and tips on watching and re-scans.
Key elements of the stroke phone reportPhrasing eligibility for IV thrombolysisPhrasing eligibility for thrombectomyRecommending next imaging stepsDocumenting uncertainty and follow-upLesson 4MRI protocols for hyperacute stroke: DWI, ADC, FLAIR, SWI, TOF/MRA, perfusion MRI parametersThis lesson explains MRI setups for very early stroke, covering DWI and ADC for core damage, FLAIR for start time guess, SWI for bleeds and clots, TOF/MRA for vessels, and perfusion tweaks for urgent calls.
Optimizing DWI and ADC for ischemic coreFLAIR mismatch and stroke onset estimationSWI for microbleeds and susceptibility vessel signTOF and contrast MRA for vessel imagingPerfusion MRI: sequence choice and timingLesson 5Reporting structure for stroke code: critical findings, side and vascular territory, estimated core/penumbra, time-sensitive recommendationsThis lesson lays out a clear stroke alert report format, highlighting bleeds, core and salvageable areas, blockage spot, side and vessel zone, plus urgent tips for clot-busters, removal, and follow-ups.
Standardized report headings and sequenceDocumenting hemorrhage and ischemic coreSide, vascular territory, and ASPECTS scoringStating thrombectomy and lysis eligibilityTime-stamped, actionable recommendationsLesson 6CT protocols: slice thickness, reconstruction, contrast timing for CTA, coverage for perfusionThis lesson reviews plain CT, CTA, and perfusion setups for acute stroke, stressing slice size, rebuild types, dye timing, and coverage to mix speed, ray dose, and clear views.
Noncontrast CT slice thickness and kernelsCTA acquisition timing and contrast bolusCT perfusion coverage and slab selectionRadiation dose, ASIR, and artifact reductionMotion management and patient positioningLesson 7Selecting emergency imaging: noncontrast CT, CT angiography, CT perfusion and MRI alternativesThis lesson guides picking urgent scan paths, weighing plain CT, CTA, perfusion CT, and MRI by time since start, patient steadiness, no-gos, and local gear for smart, proof-based plans.
Baseline noncontrast CT indicationsWhen to add CTA in the first scanRole of CT perfusion in triageWhen MRI is preferred or essentialBuilding site-specific imaging algorithmsLesson 8Vascular occlusion assessment: site of occlusion, collateral status, thrombus length and clot burden scoreThis lesson teaches steady checks for vessel blocks, spotting block site, clot size, side routes, and clot load scores on CTA/MRA, and how they shape clot removal odds and outlook.
Identifying proximal versus distal occlusionsMeasuring thrombus length on CTACollateral grading systems and scoringClot burden score and prognosisImaging predictors of recanalizationLesson 9False negatives and mimics: seizure, migraine, hypoglycemia, posterior fossa limitations and strategies to reduce errorsThis lesson tackles missed strokes and look-alikes like fits, headaches, low sugar, fake issues, and back-brain strokes, with scan tricks and tweaks to cut mistakes in early stages.
Common clinical and imaging stroke mimicsSeizure and postictal imaging appearancesMigraine aura and perfusion abnormalitiesPosterior fossa stroke CT limitationsStrategies to reduce false negativesLesson 10Key acute imaging signs: early ischemic changes, hyperdense vessel sign, territorial infarction patternsThis lesson covers main CT/MRI early lack-blood signs, like tissue shifts, dense vessel clue, grey-white blur, groove loss, and zone infarct shapes tied to vessel paths.
Early ischemic CT signs and ASPECTS useHyperdense artery sign and variantsLoss of gray–white differentiation patternsTerritorial infarct patterns by vascular territoryPosterior circulation and lacunar stroke signs
