Computed Tomography Report

     If doctors agree that a stroke has taken place, they may do other tests to determine where the stroke occurred, how large of an area is damaged, and how the blood flow with in the brain has been effected; they do this by taking a CAT scan. They may also take an ECG to determine if there is any heart disease that may have caused the stroke. In addition, they take tests to see if the patient has high blood pressure or they may test the arteries themselves because this is a major cause of stroke in most people. Catheterization, injecting dye into the arteries, and blood tests are the most common tests done. A high glucose level in the blood may reveal diabetes and high blood fats indicate thickened red blood and arteriosclerosis. There may also be a high level of red blood cells, changing the consistency of the blood. These conditions must be treated to prevent further strokes.

Associated with a large loss of blood. In the case it is the extreme amount of blood lost from her arm wound. Hemorrhage’s can be internal or external

Aneesh Singhal, MD, author of Recognition and management of stroke in young adults and adolescents, from the Clinical Journal of the American Academy of Neurology states

Hematomas occur as blood begins to pool in the tissues on the outside of blood vessels as a result of a major injury to the head or brain. Depending on the extent of the injury, however, this can cause increasing and substantial to major vessels of the head and/or brain, thereby causing severe and extensive bleeding within the brain itself. Additionally, there are also a number of different types of hematomas, depending on where the hematoma develops. According to the 2016 report issued by the Centers for Disease Control and Prevention (CDC), “different types of hematomas form depending on where the blood collects relative to the meninges. The meninges are the protective membranes surrounding

Neuroradiological imaging plays an important role in the process of diagnosing ischaemic stroke. The different imaging modalities that can be used to diagnose ischaemic stroke include computed tomography (CT), magnetic imaging resonance (MRI), and radionuclide imaging. In this article, the different modalities that contribute to the diagnostic process are discussed, with a focus on CT scan protocols.

Given the absence of a clinical test to accurately distinguish between haemorrhagic and ischaemic strokes, imaging at this early stage is vital. A non-contrast CT brain is often performed at this point although when unavailable, MRI is usually more sensitive and specific in identifying stroke lesions at the cost of longer examination times (Vymazal, Rulseh, Keller & Janouskova, 2012).

A Computed Tomography (CT) can be used to inspect large hemorrhages, that could be surgically excised, but in case of small hemorrhages, it is insensitive. Small hemorrhages could be early contusions or diffuse axon injury (DAI). SWI comes handy in determining such small hemorrhages and intracranial microhemmorhages. It is a high-resolution, fully velocity compensated, 3-dimensional gradient echo imaging sequence that is extremely sensitive to blood products in hemorrhage and deoxyhemoglobin in venous blood. Normally, CT and MRI would spot traumatic hemorrhagic lesions in cortical gray matter (GM), sub cortical white matter (WM), major white matter tracts, including corpus callosum and internal capsule, brainstem and in the ventricles. SWI helps in localizing microhemmorhages lesions at GM/WM junction. The research paper explores about a comparison of SWI and a conventional GRE performed by Tong et al. The outcome of it was a difference in lesion counts, which was highest in the brainstem/cerebellum and corpus callosum, while, lowest in the frontal & parietal-temporal-occipital GM/WM. The research article also reviews a study by Wu et al about patients with subarachnoid hemorrhage (SAH) using CT and SWI. The

Multiple image technique, such as, computed tomography (CT) to scan on the brain is the first diagnostic test, magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA), is more sensitive than CT scan. Nuclear medicine scanning techniques and cerebral angiogram (Caplan L. 2009; National Medicines Information Centre. 2011 and National Clinical Guidelines for Stroke. 2012).

Neuroimaging scans play a cardinal role in TBI diagnosis, prognosis, and deciding what treatments to give. CT is the preferred method of assessment on admission to determine structural damage and to detect (developing) intracranial hematomas (Maas, Stocchetti, Bullock, 2008). The preferred test is the computed tomography (CT) scan due to its speed, accuracy, and accessibility. The magnetic resonance imaging (MRI) exhibits more details than CT scan. MRI scan can be more advantageous than the CT scan as it is able to detect other TBI symptoms such as diffuse axonal injury (DAI). Conversely, MRI is usually not the preferred method in emergency setting due to its inability to detect brain hemorrhage and fractures, general inaccessibility, and lengthiness of the procedure.

This journal article discusses how to manage acute intracranial hemorrhage and intraventricular hemorrhage if presented to the hospital, along with its pathophysiology and what possible outcomes can result from ICH or IVH. Intracranial hemorrhage (ICH) is associated with the highest case fatality of any stroke subtype. Based on follow-up one month after ICH, 50% of patients will have passed away and only 20% of patients will have regained functional independence by 1 year. On presentation, patients with ICH are often only mildly impaired and cognitively intact. Within a few short minutes or hours, a patient 's progress can change rapidly as a result of hematoma expansion, or cerebral edema, and hydrocephalus. Intraventricular (IVH) occurs in 12-45% of patients with ICH. It also can occur independently of ICH without a significant parenchymal component. Mortality estimates for IVH in any setting range from 45-80%. The most common cause of IVH is spontaneous ICH with approximately 40% of patients with primary ICH experience IVH later on.

An occlusive stroke can also convert into a hemorrhagic stroke if the stress on the vessel wall is great enough to cause it to rupture which then causes bleeding directly into the brain tissue. Hemorrhagic strokes are the second major classification of strokes with two distinct subgroups. Intracerebral hemorrhages describe the bleeding in to the brain tissue that generally results from severe and/or sustained hypertension. The elevated blood pressure causes changes in and weakens the arterial wall making its ability to rupture easier. Damage from this type of stroke occurs from the bleeding, which causes edema, distortion, and displacement, common irritants to the brain.

Hemoglobin Electrophoresis was performed to support and give a more defined result of what the problem was. Hemoglobin Electrophoresis measures the different types of hemoglobin’s in the blood. This occurs by an electrical current being passed through the hemoglobin in a blood sample causing different types of hemoglobin to separate and form bands. The different bands include Hgb (hemoglobin) A1, Hgb A2, Hgb F, Hgb S and Hgb C. The most common type of Hemoglobin found in health children and adults is Hgb A1 which makes up 95% - 98% of the total hemoglobin. Hgb F is found in

The main objective of this experiment was to identify the different bands present in each hemoglobin samples. Based on electrophoresis of hemoglobin, the purpose was effective. The three samples of hemoglobin with appearance of blue pigment were normal hemoglobin (AA), sickle trait hemoglobin (AS), and sickle cell hemoglobin (SS). The different bands of hemoglobin samples were showed with an orange pigmentation on the gel. On the first well, it is found the normal hemoglobin that showed only one band. The normal hemoglobin has one polypeptide chain and one heme group and carry the same heme group iron that are associated with polypeptide chain of 141 (alpha) and 146 (beta) amino acids residues (Marengo, 2006). The normal hemoglobin have two kinds of chain known as alpha and beta chains.

Haemoglobin Estimation: To determine the amount of haemoglobin concentration in the patient’s blood, an anticoagulated blood sample from the patient and a healthy control, were lysed by converting haemoglobin into cyanmethaemoglobin. Potassium ferricyanide and potassium cyanide are used for this conversion to occur, and the absorbance of this colouring was measured at 540nm using a spectrophotometer. The results were recorded for the patient and the control, with the haemoglobin concentration seen below.

Nitroxyl radicals, which belong to the six-membered piperidine (TEMPO) or the five membered pyrrolidine (PROXYL) classes, are stable organic free radicals. The steric hindrance around the nitroxide group makes these compounds very stable. They are less toxic, and even serve as spin probes [1-2], spin labels [3], contrast agents [4] and antioxidants [5]. Nitroxyl radicals are widely used as spin probes for low-frequency in vivo electron spin resonance imaging (ESRI). In ESRI, the spatial as well as the spectral information of the exogenously administered spin probes is obtained. Hence, EPR images present the in vivo visualization of the spin probes often without complementary anatomical information. In contrast, MRI is a well-established modality that gives superior