Download Magnetic Resonance Imaging in Ischemic Stroke by Georg Gahn MD (auth.), RÜdiger von Kummer MD, Tobias Back MD PDF

By Georg Gahn MD (auth.), RÜdiger von Kummer MD, Tobias Back MD (eds.)

The imaging of stroke has passed through major alterations due to the quick growth in imaging expertise. This quantity, comprising 3 elements, is designed to supply a accomplished precis of the present position of MR imaging in sufferers with ischemic stroke. the 1st half outlines the scientific shows of stroke and discusses the diagnostic efficacy and healing impression of MR imaging. the second one and 3rd elements shape the middle of the quantity, and are according to a singular procedure in that the subject is gifted from very diverse viewpoints. half 2 presents an in depth presentation of the distinguishing beneficial properties of stroke from the radiologist's viewpoint. against this, half three addresses the wishes of the clinician, documenting particular stroke syndromes and their correlates on MR imaging. the final goal has been to create a well-illustrated quantity with large attraction that hyperlinks pathology, radiology and stroke drugs in an informative manner.

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Extra resources for Magnetic Resonance Imaging in Ischemic Stroke

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A practical and accessible method of imaging the penumbra could also have a major impact on the institution of other new acute stroke therapies (Davis and Donnan 2002). Neuroprotective drugs have shown great promise in animal stroke models, but have failed many times to translate into positive human studies. These negative results may at least partly relate to the fact that no method of penumbral imaging has been used to select patients Therapeutic Impact of MRI in Acute Stroke for treatment, despite the penumbra being the target for these drugs (Davis and Donnan 2002).

Most reports, however, show a strong correlation between acute PI lesions and baseline clinical scores (Barber et al. 1998a; Tong et al. 1998; Warach et al. 1996, 1999). This has led to the suggestion that the discrepancy between stroke severity, assessed with the NIHSS, and the volume of the DWI lesion (‘clinical-diffusion mismatch’) could be used as a surrogate for perfusion-diffusion mismatch. Our group has examined this hypothesis and have found that an NIHSS > 7 and DWI lesion volume < 25 cm 3 predicts the presence of perfusion-diffusion mismatch with > 90% specificity, but low sensitivity.

1995). , abciximab) might be alternative treatment arms (Abciximab in Ischemic Stroke Investigators 2000). It is predicted that EPITHET will provide more information regarding the site of vessel occlusion and response to tPA. Should this trial confirm a lower rate of major reperfusion (and correspondingly greater infarct expansion and lower penumbral salvage) with intravenous tPA for proximal occlusions, then trials of more aggressive reperfusion strategies would be indicated. A safety proof of concept study using PI/DWI (and MRA) both to select patients and for surrogate measures of outcome, would be ideal for this purpose.

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