Ischemic Infarction in Young Adults

A review of the epidemiology, workup, and causes of ischemic infarction in young adults and how it differs from that in older adults.

Course ID: Q00628 Category:
Modalities: , ,

2.5

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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:

Computed Tomography: 2.50
Procedures: 2.50
Head, Spine, and Musculoskeletal: 2.50

Magnetic Resonance Imaging: 2.50
Procedures: 2.50
Neurological: 2.50

Registered Radiologist Assistant: 2.50
Procedures: 2.50
Neurological, Vascular, and Lymphatic Sections: 2.50

Vascular-Interventional Radiography: 2.50
Procedures: 2.50
Vascular Diagnostic Procedures: 2.50

Outline

  1. Introduction
  2. Epidemiology
  3. Clinical Approach
    1. Diagnosis
    2. Determining Cause
    3. Treatment
  4. Imaging
    1. CT versus MRI
    2. Cross-Sectional Angiography
    3. Perfusion Imaging
    4. Vessel Wall Imaging
    5. Catheter Angiography
  5. Causes
  6. Cardioembolic Stroke
    1. Septic Emboli
    2. Bland Emboli
      1. Atrial Myxoma
      2. Patent Foramen Ovale
      3. Dilated Cardiomyopathy and Atrial Fibrillation
    3. Intravascular Air Emboli
    4. Fat Emboli
  7. Other Demonstrated Causes
    1. Nonatherosclerotic Vasculopathies
      1. Dissection
      2. Carotid Web
      3. Reversible Cerebral Vasoconstriction Syndrome
      4. vasculitis
      5. Recreational Drug Use
      6. Cerebral Autosomal Dominant Arteriopathy with Dubcortical Infarcts and Leukoencephalopathy
      7. Moyamoya
    2. Prothrombic Disorders
      1. Factor V Leiden Mutation
      2. Antiphospholipid Syndrome
      3. Oral Contraceptive Use
      4. Pregnancy and Puerperium
  8. Undetermined Cause
  9. Small-Vessel Occlusion
  10. Large-Artery Atherosclerosis
  11. Conclusion

Objectives

Upon completion of this course, students will:

  1. be familiar with the 5th leading cause of death in the United States
  2. identify the subtypes of ischemic infarction
  3. be familiar with the common stroke symptoms
  4. be familiar with the reference for quantifying the severity of a stroke
  5. identify the most common subtype of ischemic stroke in young adults
  6. be familiar with the catchphrase for acute stroke treatment
  7. understand the necessity for acquiring the LKWT
  8. identify the young adults with ischemic infarction that can benefit from revascularization
  9. be familiar with the advantages of using CT to assess acute ischemic stroke
  10. be familiar with the advantages of MRI to assess acute ischemic stroke
  11. be familiar with the perfusion parameters at CT perfusion imaging
  12. be familiar with vessel wall imaging techniques
  13. identify when catheter angiography is best suited for assessing stroke
  14. be familiar with TOAST
  15. identify a common cause of infectious endocarditis in young adults
  16. be familiar with common primary cardiac tumors in young adults
  17. be familiar with the percentage of adult patients with PFO
  18. identify the modality of choice when diagnosing PFO in young adults
  19. be familiar with the primary causes for cardioembolic infarcts
  20. be familiar with the presence of the MRI imaging pattern exhibited with a fat embolism
  21. identify the subcategories of the subtype Other Demonstrated Causes
  22. be familiar with vasculopathy
  23. identify the imaging modalities of choice when diagnosing a carotid dissection
  24. be familiar with the diagnostic criteria for RCVS
  25. identify the drug for treating RCVS
  26. be familiar with the defect associated with a carotid web
  27. be familiar with the routine workup for RCVS
  28. identify an illicit drug that can lead to a catastrophic ischemic injury
  29. be familiar with CADASIL
  30. be familiar with the causes of moyamoya
  31. be familiar with the percentage of moyamoya patients experiencing a cerebral infarction
  32. be familiar with factor V Leiden mutation and its relationship with ischemic infarction
  33. be familiar with the prothrombotic disorder of antiphospholipid syndrome
  34. be familiar with the risk of cerebral venous thrombosis during puerperium
  35. identify the patient risk factors associated with small-vessel occlusion