Stroke, the third leading cause of death is a medical emergency (Lloyd-Jones et al., Circulation 119:480–486, 2009). The phrase “Time is Brain” has been coined to emphasize the urgency of rapid intervention for stroke (Gomez, J Stroke Cerebrovasc Dis 3:12, 1993). For each minute, the stroke is untreated, more than two million neurons, 14 billion synapses, and 12 km (7.5 miles) of myelinated fibers may be lost (Saver, Stroke 37:263–266, 2006). Intravenous tissue plasminogen activator (tPA) is the only FDA approved treatment for a nonhemorrhagic stroke. Currently, it must be administered within 3–4.5 h of stroke onset for it to be effective in reducing infarction volume and its functional impact (Bluhmki et al., Lancet Neurol 8:1095–1102, 2009). Other non-FDA treatment approaches have been developed, including intraarterial tPA, mechanical removal of the embolus, penumbra endovascular system devices that suction the embolus through a catheter, antiplatelet and anticoagulant medications, and neuroprotective agents (Fisher et al., Stroke 40:2244–2250, 2009). All of these approaches are time sensitive and depend on the initiation of intervention soon after ischemic onset. Accordingly, there is an obvious need for a reliable and rapid means of detecting and diagnosing acute ischemic stroke to offer timely and appropriate treatment.
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The authors wish to thank Dr. Satish Dundamadappa, MD Asst. Prof of Radiology, UMASS Medical School, for providing the images.
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