title: Transcranial diffuse optical monitoring of microvascular cerebral hemodynamics after thrombolysis in ischemic stroke.
abstract: The ultimate goal of therapeutic strategies for ischemic stroke is to reestablish the blood flow to the ischemic region of the brain. However, currently, the local cerebral hemodynamics (microvascular) is almost entirely inaccessible for stroke clinicians at the patient bed-side, and the recanalization of the major cerebral arteries (macrovascular) is the only available measure to evaluate the therapy, which does not always reflect the local conditions. Here we report the case of an ischemic stroke patient whose microvascular cerebral blood flow and oxygenation were monitored by a compact hybrid diffuse optical monitor during thrombolytic therapy. This monitor combined diffuse correlation spectroscopy and near-infrared spectroscopy. The reperfusion assessed by hybrid diffuse optics temporally correlated with the recanalization of the middle cerebral artery (assessed by transcranial-Doppler) and was in agreement with the patient outcome. This study suggests that upon further investigation, diffuse optics might have a potential for bed-side acute stroke monitoring and therapy guidance by providing hemodynamics information at the microvascular level.
authors.affiliation: ICFO-Institut de Ciències Fotòniques, Mediterranean Technology Park, 08860 Castelldefels, Barcelona, Spain.
authors.forename: Peyman
authors.initials: P
authors.lastname: Zirak
authors.affiliation: Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Neurology (Stroke Unit), 08025 Barcelona, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Delgado-Mederos
authors.affiliation: Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Neurology (Stroke Unit), 08025 Barcelona, Spain.
authors.forename: Lavinia
authors.initials: L
authors.lastname: Dinia
authors.affiliation: Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Neurology (Stroke Unit), 08025 Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Carrera
authors.affiliation: Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Neurology (Stroke Unit), 08025 Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Martí-Fàbregas
authors.affiliation: ICFO-Institut de Ciències Fotòniques, Mediterranean Technology Park, 08860 Castelldefels, Barcelona, Spain.
authors.forename: Turgut
authors.initials: T
authors.lastname: Durduran
mesh_terms: D000369:Aged, 80 and over; D001794:Blood Pressure; D002545:Brain Ischemia / Q000503:physiopathology* / Q000628:therapy; D002560:Cerebrovascular Circulation; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008833:Microcirculation; D008991:Monitoring, Physiologic / Q000379:methods; D055095:Optics and Photonics; D010100:Oxygen / Q000737:chemistry; D013053:Spectrophotometry; D019265:Spectroscopy, Near-Infrared; D020521:Stroke / Q000503:physiopathology* / Q000628:therapy; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
chemical_list: D010100:Oxygen