Current opinion in neurology
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Curr. Opin. Neurol. · Aug 2019
ReviewAcute imaging for evidence-based treatment of ischemic stroke.
Until recently, intravenous thrombolysis and mechanical thrombectomy for acute stroke treatment relied on reported information on the known time of symptom onset and was limited to treatment within a narrow time window. New trials have provided evidence for imaging-based effective reperfusion treatment in an extended time window and unknown-onset stroke. This review summarizes evidence from recent clinical trials and suggests a simple algorithm for the choice of imaging modalities to guide evidence-based reperfusion treatment of acute stroke. ⋯ In stroke patients with unknown symptom onset or known symptom onset up to 24 h, advanced imaging with MRI or with CT perfusion can guide effective acute reperfusion treatment with mechanical thrombectomy and intravenous alteplase.