Cerebrovascular Disease, Stroke and Haemorrhage
Diagnose ischaemia, haemorrhage, aneurysm, vascular malformation and venous disease in acute and chronic settings.
How to prepare for the current Final FRCR Part A
Build general-radiology breadth, then practise integrating clinical context, anatomy, multimodality findings, technique and management to select the single best answer.
Core concepts
Concept 1
Localise by vascular territory and compartment, then assess time, vessel status, tissue state, mass effect and cause.
Exam cue: Localise the abnormality and identify the organ, compartment, tissue or vessel before naming a diagnosis.
Concept 2
Sequence non-contrast CT, CT angiography, perfusion, MRI, MR angiography or catheter angiography according to urgency and treatment pathway.
Exam cue: Use age, clinical setting, tempo and the complete multimodality pattern to rank the most likely explanation.
Concept 3
Communicate large-vessel occlusion, haemorrhage, herniation, aneurysmal pattern and venous thrombosis immediately.
Exam cue: Select the examination or intervention that changes management while accounting for contrast, radiation, access and urgency.
Concept 4
Apply normal and variant anatomy, modality technique, image quality and relevant imaging science to cerebrovascular disease, stroke and haemorrhage.
Risk pitfalls and guardrails
Allowing a normal early non-contrast CT to exclude ischaemic stroke or failing to check vessels and treatment eligibility.
Guardrail: Check justification, contraindications, coagulation or access, dose and complication rescue before selecting the technique.
Do not choose a merely plausible SBA option before comparing every option with the full clinical and imaging context.
Guardrail: Re-read the command word and compare every option; the task is to select the best available answer, not the first plausible one.
Memory anchors
Acute stroke imaging questions
Is there haemorrhage, large-vessel occlusion, established injury, salvageable tissue and a treatment-relevant mimic?
Subarachnoid haemorrhage pattern
Blood distribution can suggest the likely aneurysm site, but vascular imaging is needed to define the lesion.
Cerebral venous thrombosis
Consider direct thrombus and impaired venous drainage with oedema, haemorrhage or infarction crossing arterial territories.
Herniation warning
Assess cisterns, midline shift and compartmental displacement, then communicate urgently rather than only naming the mass.
Checkpoint rule
Do the check-up only after you can summarize each concept in one sentence and identify one dangerous pitfall from memory.
Knowledge Check (after reading)
Short check-up to confirm understanding of this module.
Check-up Questions
A patient develops sudden aphasia and right-sided weakness. Non-contrast CT shows a hyperdense left middle cerebral artery but no established infarct. What is the likely diagnosis?
In acute ischaemic stroke, CT perfusion shows markedly reduced cerebral blood flow, reduced cerebral blood volume and prolonged mean transit time. What tissue does this represent?
Answer all questions to submit.
Next step personalized recommendations
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Move forward only after this module is stable.
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