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Advanced Neuroimaging to Guide Acute Stroke Therapy

  • Stroke (C Sila, Section Editor)
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Abstract

Traditionally non-contrast CT has been considered the first choice imaging modality for acute stroke. Acute ischemic stroke patients presenting to the hospital within 3-hours from symptom onset and without any visible hemorrhages or large lesions on CT images are considered optimum reperfusion therapy candidates. However, non-contrast CT alone has been unable to identify best reperfusion therapy candidates outside this window. New advanced imaging techniques are now being used successfully for this purpose. Non-invasive CT or MR angiography images can be obtained during initial imaging evaluation for identification and characterization of vascular lesions, including occlusions, aneurysms, and malformations. Either CT-based perfusion imaging or MRI-based diffusion and perfusion imaging performed immediately upon arrival of a patient to the hospital helps estimate the extent of fixed core and penumbra in ischemic lesions. Patients having occlusive lesions with small fixed cores and large penumbra are preferred reperfusion therapy candidates.

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Disclosure

Conflicts of interest: G.S. Sandhu: has received research grant support in development of MRI from Siemens Medical Solutions; J.L. Sunshine: has received research grant support in development of MRI from Siemens Medical Solutions.

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  1. Department of Radiology, University Hospitals and Case Western Reserve University, Bolwell B 123, 11100 Euclid Avenue, Cleveland, OH, 44106, USA

    Gurpreet Singh Sandhu & Jeffrey L. Sunshine

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  1. Gurpreet Singh Sandhu
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Correspondence to Jeffrey L. Sunshine.

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Sandhu, G.S., Sunshine, J.L. Advanced Neuroimaging to Guide Acute Stroke Therapy. Curr Cardiol Rep 14, 741–753 (2012). https://doi.org/10.1007/s11886-012-0315-5

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