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What Does Normal CT Scan After 7 Months Of Stroke Indicate?
Question: Will q cat scan go back to looking normal months after a stroke?
Brief Answer:
It depends on the stroke size and location.
Detailed Answer:
I read your question and I understand that you must be feeling a little puzzled due to a normal Cat scan after a stroke.
It would be useful if you could give some more data on your history, ideally scans/photos of the MRI or CT reports months ago and the report this time around.
I am assuming that it was an ischemic stroke, by far the most common one, a brain infarction. Also I am assuming it was visible on MRI or CT months ago. Correct me if I am wrong by giving more info.
The answer depends on stroke size and its location. In theory a stroke means that a brain area is dead, so some brain volume is lost. If it is a small stroke though the loss of these cells might be too small to be visible on the follow up scan. When it was in the acute stage it might have been visible due to some swelling of the bordering area also a zone suffering from low blood flow, but not so low that it can't survive. Also depends by what technique it was detected the first time, MRI can detect small lesions missed by CT.
Besides the size consideration there is also the location. Certain areas of the brain, notably the posterior areas are not visualized well by CT, there can be many artifacts due to the surrounding thick bone, to visualize strokes in this area when suspected from signs and symptoms MRI is more appropriate.
I remain at your disposal for further questions.
It depends on the stroke size and location.
Detailed Answer:
I read your question and I understand that you must be feeling a little puzzled due to a normal Cat scan after a stroke.
It would be useful if you could give some more data on your history, ideally scans/photos of the MRI or CT reports months ago and the report this time around.
I am assuming that it was an ischemic stroke, by far the most common one, a brain infarction. Also I am assuming it was visible on MRI or CT months ago. Correct me if I am wrong by giving more info.
The answer depends on stroke size and its location. In theory a stroke means that a brain area is dead, so some brain volume is lost. If it is a small stroke though the loss of these cells might be too small to be visible on the follow up scan. When it was in the acute stage it might have been visible due to some swelling of the bordering area also a zone suffering from low blood flow, but not so low that it can't survive. Also depends by what technique it was detected the first time, MRI can detect small lesions missed by CT.
Besides the size consideration there is also the location. Certain areas of the brain, notably the posterior areas are not visualized well by CT, there can be many artifacts due to the surrounding thick bone, to visualize strokes in this area when suspected from signs and symptoms MRI is more appropriate.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sorry I didn't give enough information. I had a stroke 7 months ago as a result of a brain surgery for a VP shunt. I had a brain bleed, not ischemic. We actually didn't know until later. The night I got home from the hospital I had an episode where I felt like something wasn't right, couldn't yell for help or get up or move. By the time I could finally say help, I said no to calling an ambulance...I just got home and figured it was just a hiccup from my brain surgery. When things didn't really improve, I called my neurosurgeon and did a CT. It showed a large area or vasogenic edema that we've been watching for months although sometimes it was described as hypodensity. I'm 7 months out from my right side posterior parietal lobe stroke and my cat scan looks normal now. Is that to be expected? My MRI is really no good...showed the same edema, but the magnet from my shunt is causing a ton of artifact and can't see large area. Also, is a brain bleed a hemorraghic stroke, or does a bleed then cause a hemorraghic stroke?
Brief Answer:
Read below.
Detailed Answer:
Thank you for providing some more info.
A brain bleed is the same thing as a hemorrhagic stroke there isn't any difference between the two.
As for the remaining signs on CT it's a similar discussion as before regarding size. The bleed itself eventually will be reabsorbed in time, if there is a remnant it depends of how much damage the bleed caused to the adjacent tissue due to its compressive effect, mass effect.
When it's a big hemorrhage some damage is bound to happen, but when its a small one there is hope that that compressed tissue is not dead despite the swelling (edema). Because both edema and dead tissue would look hypodense on CT one can't tell one from the other with certainty, since this last scan is described as normal now that the edema has subsided, it appears that fortunately the damage was minor.
I hope to have been of help.
Read below.
Detailed Answer:
Thank you for providing some more info.
A brain bleed is the same thing as a hemorrhagic stroke there isn't any difference between the two.
As for the remaining signs on CT it's a similar discussion as before regarding size. The bleed itself eventually will be reabsorbed in time, if there is a remnant it depends of how much damage the bleed caused to the adjacent tissue due to its compressive effect, mass effect.
When it's a big hemorrhage some damage is bound to happen, but when its a small one there is hope that that compressed tissue is not dead despite the swelling (edema). Because both edema and dead tissue would look hypodense on CT one can't tell one from the other with certainty, since this last scan is described as normal now that the edema has subsided, it appears that fortunately the damage was minor.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes, that's a lot of help. I'm guessing minor damage would correlate to outward damage...which I've been lucky with. I have some balance issues, weakness on left side, numbness, working memory, attention, focus problems. I just had vision tests and my overall vision has gotten worse and I have a lot of peripheral damage...they said I have homonymous hemianopsia. Would that be aligned with only minor damage? Also, I've been put on aspirin but not blood thinners. Does that sound right since it was hemorragic?
Brief Answer:
Read below.
Detailed Answer:
Some of those symptoms could be as a remnant of the diffuse damage caused by the raised pressure due to the fluid build up for which the shunt was put, symptoms such as balance issues, memory attention and focus problems, damage which is not localized at a certain area and is not distinguishable by CT.
However symptoms weakness on one side and homonymous hemianopsia are localized signs indicating a focal damage on the right side of the brain, I would have thought some residual change due to brain loss should be visible on CT scan, perhaps they have intend as normal the lack of edema and blood.
Aspirin is actually a blood thinner, not as powerful as some others like Warfarin, but still a blood thinner. I am not sure why it was given to you for a hemorrhagic stroke, it is usually given for prevention of ischemic stroke.
If you can perhaps upload some reports I might be able to be more decisive in my answers. Feel free to ask any other questions.
Read below.
Detailed Answer:
Some of those symptoms could be as a remnant of the diffuse damage caused by the raised pressure due to the fluid build up for which the shunt was put, symptoms such as balance issues, memory attention and focus problems, damage which is not localized at a certain area and is not distinguishable by CT.
However symptoms weakness on one side and homonymous hemianopsia are localized signs indicating a focal damage on the right side of the brain, I would have thought some residual change due to brain loss should be visible on CT scan, perhaps they have intend as normal the lack of edema and blood.
Aspirin is actually a blood thinner, not as powerful as some others like Warfarin, but still a blood thinner. I am not sure why it was given to you for a hemorrhagic stroke, it is usually given for prevention of ischemic stroke.
If you can perhaps upload some reports I might be able to be more decisive in my answers. Feel free to ask any other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I'm attaching pictures of the scans. The first 2 are earlier with the edema/hypodensity. The next ones are my current ones...I actually don't have the report or results yet...it just looked to me like the edema and all is gone and back to normal.
Brief Answer:
It's the same picture
Detailed Answer:
I am afraid you must have done some mistake while uploading because it seems to be the same picture uploaded 6 times.
I don't know whether that one is the old or the new and it can't be judged by only the one slice. It looks ok to me, I see only the shunt catheter with minimal surrounding edema, which shouldn't be causing any symptoms. But it's only the one slice which doesn't show what's the picture more downwards or upwards.
Now that you say you don't have the reports though, so it means whether it is possible to be normal you meant that to your eye the edema was gone...yes that is normal, the edema would subside eventually, the remaining signs would be just an area of loss of some brain tissue compared to the other side, probably visible only to a doctor who knows the brain anatomy.
If you want to retry uploading the scans I'm here, but more slices will be needed. In the meanwhile wishing you good health.
It's the same picture
Detailed Answer:
I am afraid you must have done some mistake while uploading because it seems to be the same picture uploaded 6 times.
I don't know whether that one is the old or the new and it can't be judged by only the one slice. It looks ok to me, I see only the shunt catheter with minimal surrounding edema, which shouldn't be causing any symptoms. But it's only the one slice which doesn't show what's the picture more downwards or upwards.
Now that you say you don't have the reports though, so it means whether it is possible to be normal you meant that to your eye the edema was gone...yes that is normal, the edema would subside eventually, the remaining signs would be just an area of loss of some brain tissue compared to the other side, probably visible only to a doctor who knows the brain anatomy.
If you want to retry uploading the scans I'm here, but more slices will be needed. In the meanwhile wishing you good health.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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