Guillaume Saliou • Marie Théaudin
Claire Join-Lambert Vincent
Raphaëlle Souillard-Scemama

2014

A group of four young neuroradiologists and neurologists (Guillaume Saliou, Marie Théaudin, Claire Join-Lambert and Raphaëlle Souillard-Scemama) has rightly placed neuroimaging at the very heart of this book on neurovascular emergencies, as no evidence-based emergency treatment is available for subjects with sudden onset of hemiplegia or aphasia without at least one preliminary CT scan to exclude cerebral haemorrhage. This is so true that trials of brain CT in the ambulance are currently underway, as time is brain: one patient out of four recovers without sequelae when thrombolysis is performed within the first 90 min following onset of symptoms, versus one out of fourteen patients treated between three and four and a half hours. The authors have rightly emphasized the role of MRI, as although brain CT is able to exclude cerebral haemorrhage, visualize cerebral arteries by means of CT angiography and even allows increasingly accurate assessment of cerebral perfusion, it does not provide the fundamental information available with diffusion-weighted MRI with calculation of the apparent diffusion coefficient to assess viability of brain tissue.