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Contrast Reactions Guide

For all cases:

Always follow BLS and ACLS Guidelines as indicated and most importantly, your clinical judgement

Remember your ABCs (Airway, Breathing, Circulation)

Call for help (EMT/code team) immediately if necessary

Whenever epinephrine is administered, consider cardiac contraindications

For pediatric patients, remember appropriate medication dosing (typically weight based)

A lacunar stroke is a small anoxic injury to the central nervous system affecting an area less than 1 cm in diameter. Lacunar infarcts account for approximately 20% of all strokes. They result typically from occlusion of penetrating cerebral arterioles. The pathophysiology is often the result of arteriolar lipohyalinosis. Lacunar strokes, despite their small size, can have devestating effects if they damage certain eloquent portion of the nervous system.

1.   Pure sensory
a.    Location: ventral posterior thalamus
b.    Contralateral sensory loss

2.    Pure motor
a.    Location: PLIC, cerebral peduncle, pons or hemispheric white matter
b.    Contralateral weakness

3.    Ataxic hemiparesis
a.    Location: basis pontis but localizes poorly
b.    Contralateral weakness and ataxia

Benign calcifications are usually larger than calcifications associated with malignancy. They are usually coarser, often round with smooth margins and are much more easily seen. Calcifications associated with malignancy are usually very small and often require the use of a magnifying glass to see them well. When a specific etiology cannot be given, a description of calcifications should include the morphology and distribution of the calcifications. Benign calcifications need not always be reported. They should be reported if the interpreting radiologist is concerned that they might be misinterpreted by other observers.