PubMed · 7674740
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N Saunders, B Hammersley. 1995-09-23. Magnesium for eclampsia.. https://doi.org/10.1016/s0140-6736(95)91614-8
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We report the transesophageal echocardiogram of a patient who was admitted to the intensive care unit with a diagnosis of acute ischemic stroke, in whom a large atrial septal aneurysm (ASA) was seen bulging toward the right atrium with marked spontaneous echo contrast (SEC) inside but without thrombi, suggesting that ASA and SEC could represent a new association with higher embolic risk.
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Since acute stroke is now considered a potentially treatable medical emergency, a rapid and correct diagnosis must be made. The first step is to exclude hemorrhage, then to visualize any early ischemic changes, demonstrate the presence of hypoperfusion and locate the presence of a vascular underlying pathology as well as elucidate the presence of a potential penumbra (tissue at risk). Thanks to improvements and advances in both MR and CT technology, this can now be done in a number of ways. At the moment, CT is the most widely available and fast method for obtaining imaging of the brain and neck vessels of patients presenting with acute stroke. MRI can provide more precise information, although it remains slightly more time-consuming, but is, however, the method of choice for follow-up imaging. The main point is to take the one-stop-shopping approach where imaging of the vessels and brain is done from the aortic arch to the circle of Willis in one single session in order to have all the necessary information in the acute phase.