Acute Ischemic Stroke or Epileptic Seizure? Yield of CT Perfusion in a “Code Stroke” Situation

Comparison of CTP hypoperfusion patterns between seizure and stroke groups. A, A 61-year-old man presenting with seizure-related aphasia and right face and arm palsy: left holohemispheric hypoperfusion, absence of modification of the CBV parameter. B, A 47-year-old woman presenting with seizure-related aphasia and right-arm palsy: hypoperfusion, which may correspond with a vascular territory, and a relative decrease (33%) of the CBV parameter in the same area. C, A 60-year-old man with stroke-related aphasia and right-arm and facial palsy: hypoperfusion corresponding with posterior territory of the left middle cerebral artery, absence of modification of the CBV parameter, and MCA acute ischemic stroke within the hypoperfusion region on follow-up MR imaging. D, A 77-year-old man with stroke-related dysarthria and left facial palsy: hypoperfusion corresponding to a part of the cortical ribbon of the right medium cerebral artery, no modification of the CBV parameter, and MCA acute ischemic stroke within the hypoperfusion territory on follow-up MR imaging.