Neuroimaging clinics of North America
-
Neuroimaging Clin. N. Am. · Nov 2018
Review Case ReportsClot Pathophysiology: Why Is It Clinically Important?
Cerebral ischemic stroke treatment may change significantly now that clots are actually physically removed from the patient using thrombectomy. This allows for an analysis of the content of the clots as well as the correlation of the imaging findings and the clot behavior and morphology. This article illustrates how the interaction of different clots varies in the clinical setting and how analysis of clot composition, as well as the search for new pharmacologic targets, can lead to a better understanding of the pathophysiology and therapy resistance, in turn providing possibilities for a better approach in the treatment.
-
Teleradiology, transfer of radiology images to a distant diagnostician, has existed for more than 50 years and is a fundamental element in telestroke programs. Teleradiology allows access to expertise for accurate and rapid interpretation of noncontrast CT (NCCT) scans to distinguish ischemic stroke from hemorrhagic stroke. ⋯ Innovations in CT software and ambulance-based CT scans are significantly improving outcomes by matching patients to effective treatment paradigms. This article reviews telestroke models, NCCT interpretation pearls, and access challenges to the latest neuroradiology technology within rural and underserved regions.
-
Given the need for early restoration of blood flow and preservation of partially damaged brain cells after ischemic stroke, the noninterventional treatment of stroke relies heavily on the speedy recognition and classification of the clinical syndrome. Initiation of systemic thrombolysis with careful observation of contraindications within the 3.0 (4.5)-hour time window is the approved therapy of choice. Management of hemorrhagic complications and resumption of oral anticoagulation if indicated are also discussed in this article.
-
Neuroimaging Clin. N. Am. · Nov 2018
ReviewNeuro-Interventional Management of Acute Ischemic Stroke.
Restoration of cerebral blood flow is the most important step in preventing irreversible damage to hypoperfused brain cells after ischemic stroke from large-vessel occlusion. For those patients who do not respond to (or are not eligible for) intravenous thrombolysis, endovascular therapy has become standard of care. ⋯ At this time, one can reasonably anticipate that more patients will be treated, and that outcomes will keep improving. This article discusses in detail recent advances in endovascular stroke therapy.