Computed tomography perfusion imaging in the selection of acute stroke patients to undergo emergent carotid endarterectomy.

Severe acute stroke patients with critical carotid stenosis or occlusion without intracranial thrombus typically do not undergo emergent carotid thromboendarterectomy (CEA) because of the risk of reperfusion-related intracranial hemorrhage. Past studies have not consistently demonstrated benefit of early operative intervention. Cerebral computed tomography (CT), cervical and cerebral CT angiography (CTA), and cerebral CT perfusion (CTP) imaging may identify a subset of acute stroke patients without intracranial thrombus who may benefit from emergent CEA.

A rare cause of seizure masquerading as neoplasm.

The authors report the case of a young man with no significant medical history who presented with new-onset seizure and mass-like lesions isolated to the left cerebral hemisphere relating to malignancy. Biopsy revealed findings consistent with angiitis and investigations for secondary causes of angiitis was negative. The diagnosis of primary angiitis of the central nervous system was made and the patient has responded well to treatment.