title: Role of diffusion and perfusion MRI in selecting patients for reperfusion therapies.
abstract: After onset of ischemic stroke, potentially viable tissue at risk (ischemic penumbra) may be salvageable. Currently, intravenous alteplase is approved for up to 4.5 hours after symptom onset of acute ischemic stroke. Increasing this time window may allow many more patients to be treated. The ability to use MRI to help define the irreversibly damaged brain (infarct core) and the reversible ischemic penumbra shows great promise for stroke treatment. Recent advances in penumbral imaging technology may enable a phase III trial of an intravenous thrombolytic to be performed beyond 4.5 hours using techniques to select patients with penumbral tissue.
authors.affiliation: Stanford Stroke Center, Department of Neurology and Neurological Sciences, Stanford University Medical Center, 780 Welch Road, Palo Alto, CA 94304, USA. mikayel@gmail.com
authors.forename: Mikayel
authors.initials: M
authors.lastname: Grigoryan
authors.forename: Christie E
authors.initials: CE
authors.lastname: Tung
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Albers
mesh_terms: D002533:Cerebral Angiography / Q000639:trends*; D038524:Diffusion Magnetic Resonance Imaging / Q000639:trends*; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000639:trends*; D015424:Reperfusion / Q000639:trends*; D020521:Stroke / Q000175:diagnosis* / Q000628:therapy*