title: Advanced neuroimaging in acute ischemic stroke: extending the time window for treatment.
abstract: Early treatment of ischemic stroke with thrombolytics is associated with improved outcomes, but few stroke patients receive thrombolytic treatment in part due to the 3-hour time window. Advances in neuroimaging may help to aid in the selection of patients who may still benefit from thrombolytic treatment beyond conventional time-based guidelines. In this article the authors review the available literature in support of using advanced neuroimaging to select patients for treatment beyond the 3-hour time window cutoff and explore potential applications and limitations of perfusion imaging in the treatment of acute ischemic stroke.
authors.affiliation: Department of Neurological Surgery, University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA. eduffis@gmail.com
authors.forename: E Jesus
authors.initials: EJ
authors.lastname: Duffis
authors.forename: Zaid
authors.initials: Z
authors.lastname: Al-Qudah
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Prestigiacomo
authors.forename: Chirag
authors.initials: C
authors.lastname: Gandhi
mesh_terms: D000208:Acute Disease; D002545:Brain Ischemia / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy*; D003952:Diagnostic Imaging / Q000379:methods* / Q000639:trends; D004632:Emergency Medical Services / Q000592:standards / Q000639:trends; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods / Q000639:trends; D055420:Perfusion Imaging / Q000379:methods / Q000639:trends; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods / Q000592:standards*; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000639:trends