Identification Of The Ischemic Penumbra And The Infarct Core In Acute Stroke Using Ct Perfusion Imaging
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Identification Of The Ischemic Penumbra And The Infarct Core In Acute Stroke Using Ct Perfusion Imaging
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Author : Blake D. Murphy
language : en
Publisher:
Release Date : 2006
Identification Of The Ischemic Penumbra And The Infarct Core In Acute Stroke Using Ct Perfusion Imaging written by Blake D. Murphy and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2006 with categories.
The Ischemic Penumbra Still The Target For Stroke Therapies
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Author : Argye E. Hillis
language : en
Publisher: Frontiers Media SA
Release Date : 2015-07-23
The Ischemic Penumbra Still The Target For Stroke Therapies written by Argye E. Hillis and has been published by Frontiers Media SA this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015-07-23 with Acute ischemic stroke categories.
The ischemic penumbra was initially defined by Symon, Lassen and colleagues in the 1970s as an area of brain tissue with inadequate blood flow to maintain electric activity of neurons but adequate blood flow to preserve the function of the ion channels. This area of tissue, receiving enough blood to survive but not enough to function, often surrounds or abuts the irreversibly damaged core in ischemic stroke. It was shown that if blood flow could be restored to this area of marginal perfusion, the tissue could survive and function again, and growth of the core could be prevented. Based on seminal PET studies, penumbra or "penumbral tissue" eventually took on a subtly different meaning - the area of brain that is destined to progress to infarct unless blood flow is restored within a particular time window. The penumbra thus became the target for all acute stroke interventions - to preserve viability of the tissue and restore function. New imaging techniques, including diffusion and perfusion MRI and CT perfusion, were developed to rapidly identify individuals with penumbra, who were thought to be the best candidates for aggressive interventions to restore blood flow, particularly beyond the licensed time-window for IV thrombolysis. However, most clinical trials have failed to establish the usefulness of identifying candidates for treatment in this way using pre-specified protocols and primary endpoints. These trials have used different and sometimes unvalidated thresholds of hypoperfusion as well as irreversible infarct and various definitions of significant penumbra (or mismatch between irreversible infarct and hypoperfused, but salvageable tissue), and reanalysis of their data using more refined image processing showed post-hoc positivity. They have also evaluated outcome in a variety of ways, with few studies measuring the direct effect of restoring blood flow on the function of the penumbral tissue. Therefore, important remaining questions include how to define, characterize, and image the penumbra in acute stroke to achieve the greatest reliability and validity for what we want to measure, and whether this concept, so defined, provides an optimal target for stroke therapy using state-of-the-art trial design.
Mr And Ct Perfusion And Pharmacokinetic Imaging
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Author : Roland Bammer
language : en
Publisher: LWW
Release Date : 2016
Mr And Ct Perfusion And Pharmacokinetic Imaging written by Roland Bammer and has been published by LWW this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016 with Brain categories.
"A practical example of the increasingly important role of perfusion in clinical practice is the identification of infarct core and ischemic penumbra in acute stroke patients. In early 2015, several clinical trials that focused on endovascular treatment of large vessel occlusion in stroke patients demonstrated remarkable outcomes. The most successful trials used perfusion metrics for patient selection, specifically to identify patients with a small core, sufficient salvageable tissue, and ample collateral flow"--
Mr And Ct Perfusion Imaging
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Author :
language : en
Publisher:
Release Date : 2016
Mr And Ct Perfusion Imaging written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016 with Brain categories.
"A practical example of the increasingly important role of perfusion in clinical practice is the identification of infarct core and ischemic penumbra in acute stroke patients. In early 2015, several clinical trials that focused on endovascular treatment of large vessel occlusion in stroke patients demonstrated remarkable outcomes. The most successful trials used perfusion metrics for patient selection, specifically to identify patients with a small core, sufficient salvageable tissue, and ample collateral flow"--Provided by publisher.
Acute Ischemic Stroke
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Author : R. Gilberto González
language : en
Publisher: Springer Science & Business Media
Release Date : 2010-10-05
Acute Ischemic Stroke written by R. Gilberto González and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010-10-05 with Medical categories.
This updated second edition of Acute Ischemic Stroke: Imaging and Intervention provides a comprehensive account of the state of the art in the diagnosis and treatment of acute ischemic stroke. The basic format of the first edition has been retained, with sections on fundamentals such as pathophysiology and causes, imaging techniques and interventions. However, each chapter has been revised to reflect the important recent progress in advanced neuroimaging and the use of interventional tools. In addition, a new chapter is included on the classification instruments for ischemic stroke and their use in predicting outcomes and therapeutic triage. All of the authors are internationally recognized experts and members of the interdisciplinary stroke team at the Massachusetts General Hospital and Harvard Medical School. The text is supported by numerous informative illustrations, and ease of reference is ensured through the inclusion of suitable tables. This book will serve as a unique source of up-to-date information for neurologists, emergency physicians, radiologists and other health care providers who care for the patient with acute ischemic stroke.
The Ischemic Penumbra
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Author : Geoffrey A. Donnan
language : en
Publisher: CRC Press
Release Date : 2007-04-13
The Ischemic Penumbra written by Geoffrey A. Donnan and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2007-04-13 with Medical categories.
The Ischemic Penumbra presents the current status of concepts and research on this topic and identifies the latest methods for clinicians to quickly and efficiently recognize viable cerebral tissue for enhanced stroke management. Focusing on state-of-the-science technologies and current trends, the book examines imaging strategies utilizing PET, SP
Mr And Ct Perfusion Imaging And Pharmacokinetic Imaging
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Author :
language : en
Publisher:
Release Date : 2016
Mr And Ct Perfusion Imaging And Pharmacokinetic Imaging written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016 with categories.
"A practical example of the increasingly important role of perfusion in clinical practice is the identification of infarct core and ischemic penumbra in acute stroke patients. In early 2015, several clinical trials that focused on endovascular treatment of large vessel occlusion in stroke patients demonstrated remarkable outcomes. The most successful trials used perfusion metrics for patient selection, specifically to identify patients with a small core, sufficient salvageable tissue, and ample collateral flow"--Provided by publisher.
Acute Ischemic Stroke
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Author : R. Gilberto González
language : en
Publisher: Springer Science & Business Media
Release Date : 2006-03-06
Acute Ischemic Stroke written by R. Gilberto González and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2006-03-06 with Medical categories.
Up-to-date, detailed practical guide for neuroimaging of the acute ischemic stroke patients Experienced authors in the field of neuro imaging
Good Collaterals Are A Major Determinant Of The Infarct Core But Not Penumbra Volume In The Acute Phase Of Stroke
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Author : Stefania Nannoni
language : en
Publisher:
Release Date : 2017
Good Collaterals Are A Major Determinant Of The Infarct Core But Not Penumbra Volume In The Acute Phase Of Stroke written by Stefania Nannoni and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017 with categories.
IntroductionDeterminants of early loss of ischemic tissue (core) or its prolonged survival (penumbra) in acute ischemic stroke are incompletely understood. We aimed to identify radiological variables associated with core and penumbra volumes on CT perfusion (CTP).MethodsIn the Acute STroke Registry and Analysis of Lausanne (2003-2015), we identified 415 patients with good quality CTP and proximal MCA occlusion. Volumes of core, penumbra, and mismatch ratio [MR = (core+penumbra)/core)] were calculated using established thresholds. Collaterals were scored from 0 (absent) to 3 (100% or more) and analysed in an ordinal way. CTP volumes were correlated with multiple radiological variables in multivariate regression analysis. ResultsThe median age was 69 years (IQR 21), 49% were female, admission NIHSS was 16 (IQR 11), and delay to imaging 2.2 hours (IQR 1.9). Lower core volumes were associated with higher ASPECTS, absence of hyperdense MCA sign, lower clot burden and good collaterals (see Table). Higher penumbra volumes were correlated with higher clot burden and non-distal intracranial occlusion, but not with collaterals. Higher MR was found in absence of hyperdense MCA sign and of distal intracranial occlusion, and with good collaterals.ConclusionsIn acute stroke, good collaterals were associated with lower core, but not with higher penumbra volumes. This suggests a major role of collaterals in early tissue loss, but its limited significance as marker of salvageable tissue.
The Stroke Book
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Author : Michel T. Torbey
language : en
Publisher: Cambridge University Press
Release Date : 2013-07-18
The Stroke Book written by Michel T. Torbey and has been published by Cambridge University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-07-18 with Medical categories.
An essential companion for busy professionals seeking to navigate stroke-related clinical situations successfully and make quick informed treatment decisions.