Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Nov 2018
ReviewClinical Distinction of Cerebral Ischemia and Triaging of Patients in the Emergency Department: Mimics, Wake-ups, Late Strokes, and Chameleons.
Non-stroke conditions may present in ways suggestive of ischemic stroke (ie, stroke mimic). Alternatively, the clinical presentation of ischemic stroke can vary considerably and may appear similar to another condition (ie, stroke chameleon). Common and uncommon mimics and chameleons are presented with discussion of key considerations to improve diagnostic accuracy.
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Neuroimaging Clin. N. Am. · Nov 2018
ReviewMR Imaging Selection of Acute Stroke Patients with Emergent Large Vessel Occlusions for Thrombectomy.
Acute stroke caused by large vessel occlusions (LVOs) are common. The time window to treat is up to 24 hours, and the most important factor is the size of the ischemic core. ⋯ The necessary sequences are obtainable rapidly, comparable to computed tomography scans. Available evidence suggests that most patients with LVOs are slow progressors defined as having a small core 6 hours or more after ictus onset.
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Neuroimaging Clin. N. Am. · Nov 2018
ReviewAdvanced Neuroimaging of Acute Ischemic Stroke: Penumbra and Collateral Assessment.
Acute ischemic stroke (AIS) occurs when there is a sudden loss in cerebral blood flow due to embolic or thromboembolic occlusion of a cerebral or cervical artery. Patients with AIS require emergent neuroimaging to guide treatment, which includes intravenous thrombolysis and endovascular mechanical thrombectomy (EMT). Recent advances in AIS treatment by EMT has been driven in part by advances in computed tomography (CT) and MR imaging neuroimaging evaluation of ischemic penumbra and pial collateral vessels. The authors review advanced noninvasive brain imaging by CT and MR imaging for the evaluation of AIS focusing on penumbral and collateral imaging.
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Neuroimaging Clin. N. Am. · Nov 2018
ReviewComputed Tomography, Computed Tomography Angiography, and Perfusion Computed Tomography Evaluation of Acute Ischemic Stroke.
This review outlines the current role of the individual components of multimodal computed tomography (computed tomography, computed tomography angiography, and perfusion computed tomography) in the evaluation of patients with acute ischemic stroke.
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Neuroimaging Clin. N. Am. · Nov 2018
ReviewReperfusion Changes After Stroke and Practical Approaches for Neuroprotection.
Reperfusion is the first line of care in a growing number of eligible acute ischemic stroke patients. Early reperfusion with thrombolytic drugs and endovascular mechanical devices is associated with improved outcome and lower mortality rates compared with natural history. ⋯ In this article, the functional and structural changes and underlying molecular mechanisms of ischemia and reperfusion are reviewed. The pathways that lead to reperfusion injury and novel neuroprotective strategies with endogenous properties are discussed.