Neuroimaging in Acute Ischemic Stroke

  • Shashidhara Nanjundaswamy
  • Ronald A. Cohen
  • Marc Fisher


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.


Apparent Diffusion Coefficient Magnetic Resonance Angiography Diffusion Weight Image Stroke Onset Compute Tomography Perfusion 



The authors wish to thank Dr. Satish Dundamadappa, MD Asst. Prof of Radiology, UMASS Medical School, for providing the images.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Shashidhara Nanjundaswamy
  • Ronald A. Cohen
  • Marc Fisher
    • 1
  1. 1.UMASS-Memorial Medical CenterWorcesterUSA

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