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Stroke MRI pp 75-81 | Cite as

Impact of Stroke MRI on Therapeutic Decision Making

  • P. D. Schellinger
  • J. B. Fiebach
  • S. Warach
  • W. Hacke
Chapter
  • 208 Downloads

Abstract

Intravenous thrombolysis with rt-PA is effective in acute stroke patients [304, 305]. Although tPA is the only proven therapy for acute stroke, only 3% to 4% of all stroke patients are currently treated [251]. The limited use of rt-PA is partly due to safety concerns of neurologists, internal medicine and emergency physicians [21, 170] and the narrow therapeutic time window. The extension of the therapeutic window would be an important step towards a broader application. It has been argued that the selection of stroke patients likely to respond to thrombolysis might improve functional outcome within the 3 h time window and extend the window towards 6 hours after stroke onset [2, 131]. In this chapter we discuss, how stroke MRI can be used to guide acute therapy especially whether to give or withhold thrombolytic therapy. In essence, the presence of a vessel occlusion according to MRA is associated with a PWI/DWI-mismatch, the stroke MRI setting that defines the ideal candidate for thrombolysis [281, 307].

Keywords

Time Window Thrombolytic Therapy Vessel Occlusion Acute Stroke Patient Lacunar Stroke 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2003

Authors and Affiliations

  • P. D. Schellinger
  • J. B. Fiebach
  • S. Warach
  • W. Hacke

There are no affiliations available

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