Imaging of acute stroke.
Thrombolytic therapy has led to a higher proportion of patients presenting to hospital early, and this, with parallel developments in imaging technology, has greatly improved the understanding of acute stroke pathophysiology. Additionally, MRI, including diffusion-weighted imaging (DWI) and gradient echo, or T2*, imaging is important in understanding basic structural information--such as distinguishing acute ischaemia from haemorrhage. It has also greatly increased sensitivity in the diagnosis of acute cerebral ischaemia. The pathophysiology of the ischaemic penumbra can now be assessed with CT or MRI-based perfusion imaging techniques, which are widely available and clinically applicable. Pathophysiological information from CT or MRI increasingly helps clinical trial design, may allow targeted therapy in individual patients, and may extend the time scale for reperfusion therapy.
Muir
Keith W
KW
Division of Clinical Neurosciences, University of Glasgow, Institute of Neurological Sciences, Southern General Hospital, Glasgow.
Buchan
Alastair
A
von Kummer
Rudiger
R
Rother
Joachim
J
Baron
Jean-Claude
JC
D000818:Animals; D002545:Brain Ischemia / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D003952:Diagnostic Imaging / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D015912:Thrombolytic Therapy