Beyond mismatch: evolving paradigms in imaging the ischemic penumbra with multimodal magnetic resonance imaging.

Abstract:

BACKGROUND:The ability to quickly and efficiently identify the ischemic penumbra in the acute stroke clinical setting is an important goal for stroke researchers and clinicians. Early and accurate identification of potentially salvageable versus irreversibly infarcted brain tissue may enable selection of the most appropriate candidates for early stroke therapies and identify patients who may still benefit from late recanalization or neuroprotective treatment. Recent advances in magnetic resonance imaging of the ischemic penumbra have been driven by serial MRI studies characterizing the natural evolution of cerebral infarction as well as the brain's response to reperfusion. SUMMARY OF COMMENT:Based on these studies, various models for imaging the penumbra with MRI have been proposed, including the pioneering diffusion-perfusion mismatch model and later multivariate approaches. Each model has its own unique advantages and disadvantages. CONCLUSIONS:There now are sufficient data to support paradigm shifts in a variety of central tenets regarding MRI and the ischemic penumbra. These include the insights that diffusion-perfusion mismatch does not optimally define the penumbra; that early diffusion lesions are in part reversible and often include both irreversibly infarcted tissue and penumbra; that the visible zone of perfusion abnormality overestimates the penumbra by including regions of benign oligemia; that MRI is a very practical method for acute stroke imaging; and that therapeutic salvage of the ischemic penumbra has been demonstrated in humans using diffusion-perfusion MRI.

journal_name

Stroke

journal_title

Stroke

authors

Kidwell CS,Alger JR,Saver JL

doi

10.1161/01.STR.0000097608.38779.CC

subject

Has Abstract

pub_date

2003-11-01 00:00:00

pages

2729-35

issue

11

eissn

0039-2499

issn

1524-4628

pii

01.STR.0000097608.38779.CC

journal_volume

34

pub_type

杂志文章,评审

相关文献

STROKE文献大全
  • Impairment of vasodilator function in basilar arteries from aged rats.

    abstract:BACKGROUND AND PURPOSE:Aging is associated with a reduction in cerebral perfusion. Impaired vasodilatation in large brain arteries could be implicated. This study sought age-related changes in vasodilator responses to norepinephrine in rat basilar artery and investigated which aspects of norepinephrine's action are res...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.28.9.1812

    authors: Arribas SM,Vila E,McGrath JC

    更新日期:1997-09-01 00:00:00

  • Increased release of tumor necrosis factor-alpha into the cerebrospinal fluid and peripheral circulation of aged rats.

    abstract:BACKGROUND AND PURPOSE:We earlier reported that risk factors for stroke prepare brain stem tissue for a modified Shwartzman reaction, including the development of ischemia and hemorrhage and the production of tumor necrosis factor-alpha, after a provocative dose of lipopolysaccharide. In the present study, we sought to...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.24.6.880

    authors: Sirén AL,Liu Y,Feuerstein G,Hallenbeck JM

    更新日期:1993-06-01 00:00:00

  • Uric acid levels are relevant in patients with stroke treated with thrombolysis.

    abstract:BACKGROUND AND PURPOSE:Uric acid (UA) is a neuroprotective antioxidant that improves the benefits of alteplase in experimental ischemia. However, it is unknown whether endogenous UA also influences the response to thrombolysis in patients with stroke. METHODS:A total of 317 consecutive patients treated with thrombolys...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1161/STROKEAHA.110.596528

    authors: Amaro S,Urra X,Gómez-Choco M,Obach V,Cervera A,Vargas M,Torres F,Rios J,Planas AM,Chamorro A

    更新日期:2011-01-01 00:00:00

  • Effects of hypothermia on evoked potentials, magnetic resonance imaging, and blood flow in focal ischemia in rabbits.

    abstract:BACKGROUND AND PURPOSE:Mild hypothermia has been shown to ameliorate neuronal damage due to cerebral ischemia. In our study, the influence of mild-to-moderate hypothermia was examined in a rabbit model of focal cerebral ischemia. METHODS:After 4 hours of permanent ischemia induced by occlusion of the anterior and midd...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.23.6.889

    authors: Lo EH,Steinberg GK

    更新日期:1992-06-01 00:00:00

  • Long-term survival after first-ever stroke: the Oxfordshire Community Stroke Project.

    abstract:BACKGROUND AND PURPOSE:There have been relatively few community-based studies of long-term prognosis after acute stroke. This study aimed to provide precise estimates of the absolute and relative risks of dying in an unselected cohort of patients with a first-ever stroke. METHODS:Six hundred seventy-five patients were...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.24.6.796

    authors: Dennis MS,Burn JP,Sandercock PA,Bamford JM,Wade DT,Warlow CP

    更新日期:1993-06-01 00:00:00

  • Effect of dietary modification on incident carotid artery disease in postmenopausal women: results from the women's health initiative dietary modification trial.

    abstract:BACKGROUND AND PURPOSE:Because the diagnosis and treatment of carotid artery disease may reduce the rate of stroke, the aim of this study was to determine whether a diet intervention was associated with incident carotid artery disease. METHODS:Participants were 48 835 postmenopausal women aged 50 to 79 years who were ...

    journal_title:Stroke

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1161/STROKEAHA.114.005096

    authors: Allison MA,Aragaki A,Eaton C,Li W,Van Horn L,Daviglus ML,Berger JS

    更新日期:2014-06-01 00:00:00

  • Measurement of regional brain glucose utilization in vivo using [2(-14)C] glucose.

    abstract::A new technique is described for the autoradiographic determination of regional brain glucose metabolism employing 14C labeled glucose as substrate and measurement principles previously described for whole brain. Regional glucose values correlate closely with those reported for the 14C-deoxyglucose technique. The meth...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.10.6.690

    authors: Hawkins R,Hass WK,Ransohoff J

    更新日期:1979-11-01 00:00:00

  • Fibrin and Platelet-Rich Composition in Retrieved Thrombi Hallmarks Stroke With Active Cancer.

    abstract:BACKGROUND AND PURPOSE:We aim to investigate whether histopathologic examination of thrombi retrieved from acute ischemic stroke patients undergoing endovascular treatment could distinguish cancer-related stroke from other etiologies. METHODS:Thrombi from patients undergoing endovascular treatment were analyzed. The e...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.120.032069

    authors: Fu CH,Chen CH,Lin YH,Lee CW,Tsai LK,Tang SC,Shun CT,Jeng JS

    更新日期:2020-12-01 00:00:00

  • Stereotactic treatment of intracerebral hematoma by means of a plasminogen activator: a multicenter randomized controlled trial (SICHPA).

    abstract:BACKGROUND AND PURPOSE:Treatment of intracerebral hematoma (ICH) is controversial. An advantage of neurosurgical intervention over conservative treatment of ICH has not been established. Recent reports suggest a favorable effect of stereotactic blood clot removal after liquefaction by means of a plasminogen activator. ...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1161/01.STR.0000063367.52044.40

    authors: Teernstra OP,Evers SM,Lodder J,Leffers P,Franke CL,Blaauw G,Multicenter randomized controlled trial (SICHPA).

    更新日期:2003-04-01 00:00:00

  • Prevalence of apolipoprotein E alleles in healthy subjects and survivors of ischemic stroke: an Italian Case-Control Study.

    abstract:BACKGROUND AND PURPOSE:The epsilon4 allele of the apolipoprotein E (apoE) has been related to the occurrence of myocardial infarction, but its association with ischemic stroke is controversial. We have evaluated the relation between apoE alleles and the occurrence of cerebrovascular ischemia. METHODS:The apoE epsilon ...

    journal_title:Stroke

    pub_type: 杂志文章,多中心研究

    doi:10.1161/01.str.29.2.399

    authors: Margaglione M,Seripa D,Gravina C,Grandone E,Vecchione G,Cappucci G,Merla G,Papa S,Postiglione A,Di Minno G,Fazio VM

    更新日期:1998-02-01 00:00:00

  • Early component changes in corticomotor evoked potentials following experimental stroke.

    abstract::Corticomotor evoked potentials have recently been used in experimental animals and patients as a measure of neurologic function after stroke. However, little is known about the fundamental electrophysiologic properties contributing to the formation of these potentials. To define some of these properties, corticomotor ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.18.6.1141

    authors: Simpson RK Jr,Baskin DS

    更新日期:1987-11-01 00:00:00

  • Human neural stem cell grafts modify microglial response and enhance axonal sprouting in neonatal hypoxic-ischemic brain injury.

    abstract:BACKGROUND AND PURPOSE:Hypoxic-ischemic (HI) brain injury in newborn infants represents a major cause of cerebral palsy, development delay, and epilepsy. Stem cell-based therapy has the potential to rescue and replace the ischemic tissue caused by HI and to restore function. However, the mechanisms by which stem cell t...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.109.573691

    authors: Daadi MM,Davis AS,Arac A,Li Z,Maag AL,Bhatnagar R,Jiang K,Sun G,Wu JC,Steinberg GK

    更新日期:2010-03-01 00:00:00

  • Impact of basilar artery vasospasm on outcome in patients with severe cerebral vasospasm after aneurysmal subarachnoid hemorrhage.

    abstract:BACKGROUND AND PURPOSE:The purpose of the present study was to evaluate the impact of basilar artery (BA) vasospasm on outcome in patients with severe vasospasm after aneurysmal subarachnoid hemorrhage (aSAH). METHODS:Sixty-five patients with clinically suspect severe cerebral vasospasm after aSAH underwent cerebral a...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000244765.29502.85

    authors: Sviri GE,Newell DW,Lewis DH,Douville C,Ghodke B,Chowdhary M,Lam AM,Haynor D,Zaaroor M,Britz GW

    更新日期:2006-11-01 00:00:00

  • Brain pHi, cerebral blood flow, and NADH fluorescence during severe incomplete global ischemia in rabbits.

    abstract:BACKGROUND AND PURPOSE:The aim of this experiment was to study the serial changes in brain intracellular pH, cerebral blood flow, and the oxidation/reduction level of intramitochondrial nicotinamide adenine dinucleotide fluorescence across the cortical surface during severe incomplete global ischemia. METHODS:Reduced ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.24.3.435

    authors: Tomlinson FH,Anderson RE,Meyer FB

    更新日期:1993-03-01 00:00:00

  • Genomics of preconditioning.

    abstract::Brief episodes of ischemia can protect against subsequent damaging ischemic events; however, the molecular mechanisms responsible for protection are poorly understood. Identifying genes involved in this process could provide insight into cell survival and treatment of stroke. We developed a murine model of ischemic pr...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000143735.89281.bb

    authors: Stenzel-Poore MP,Stevens SL,Simon RP

    更新日期:2004-11-01 00:00:00

  • Extent of acute hydrocephalus after aneurysmal subarachnoid hemorrhage as a risk factor for delayed cerebral infarction.

    abstract:BACKGROUND AND PURPOSE:Delayed cerebral infarction (DCI) is an important cause of poor outcome after subarachnoid hemorrhage. Cerebral perfusion is a predictor for DCI. Because acute hydrocephalus may impair cerebral perfusion, we evaluated the predictive value of the extent of acute hydrocephalus on the development of...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.107.484220

    authors: Bakker AM,Dorhout Mees SM,Algra A,Rinkel GJ

    更新日期:2007-09-01 00:00:00

  • Intracerebral hemorrhage and head trauma: common effects and common mechanisms of injury.

    abstract::Nontraumatic intracerebral hemorrhage (ICH) remains a devastating condition with 30-day mortality rates of 35% to 52%. Until the pathophysiology of this condition is better understood, it will not be possible to develop effective therapies. Studies of cerebral blood flow and metabolism in patients with acute ICH show ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.110.595058

    authors: Powers WJ

    更新日期:2010-10-01 00:00:00

  • Primary care physician-reported secondary and tertiary stroke prevention practices. A comparison between the United States and the United Kingdom.

    abstract:BACKGROUND AND PURPOSE:Stroke is a major healthcare problem in both the United States (US) and the United Kingdom (UK). Little comparative data are available concerning how generalist physicians in the two countries approach the management of patients at high risk of stroke. METHODS:Contemporaneous surveys of random s...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.28.4.746

    authors: Goldstein LB,Farmer A,Matchar DB

    更新日期:1997-04-01 00:00:00

  • Sensory sequelae of medullary infarction: differences between lateral and medial medullary syndrome.

    abstract:BACKGROUND AND PURPOSE:A comparison between long-term sensory sequelae of lateral medullary infarction (LMI) and medial medullary infarction (MMI) has never been made. METHODS:We studied 55 patients with medullary infarction (41 with LMI and 14 with MMI) who were followed up for >6 months. We examined and interviewed ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.30.12.2697

    authors: Kim JS,Choi-Kwon S

    更新日期:1999-12-01 00:00:00

  • Remodeling of the corticospinal innervation and spontaneous behavioral recovery after ischemic stroke in adult mice.

    abstract:BACKGROUND AND PURPOSE:To elucidate how the motor pathways rewire the denervated tissue after stroke, we investigated remodeling of the corticospinal tract (CST) in transgenic mice with yellow fluorescent protein CST labeling in conjunction with transsynaptic pseudorabies virus retrograde tracing. METHODS:Adult male C...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.109.547265

    authors: Liu Z,Zhang RL,Li Y,Cui Y,Chopp M

    更新日期:2009-07-01 00:00:00

  • Acute ischemic stroke from fibrocartilaginous embolism to the middle cerebral artery.

    abstract:BACKGROUND AND PURPOSE:Fibrocartilaginous embolism from the nucleus pulposus has been reported as a rare cause of spinal cord ischemia. We were unable to find previous reports of embolism from this source to cerebral arteries. CASE DESCRIPTION:A previously healthy 17-year-old girl fell during a basketball game. Left h...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.24.5.738

    authors: Toro-González G,Navarro-Román L,Román GC,Cantillo J,Serrano B,Herrera M,Vergara I

    更新日期:1993-05-01 00:00:00

  • Focal ischemia enhances choline output and decreases acetylcholine output from rat cerebral cortex.

    abstract::Choline concentration is rate limiting in the synthesis of acetylcholine. There is a negative arteriovenous difference for choline concentration across the brain, indicating the steady output of choline from this organ. Cerebral ischemia may increase extracellular choline concentration by interfering with its removal ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.20.1.92

    authors: Scremin OU,Jenden DJ

    更新日期:1989-01-01 00:00:00

  • Sulcal effacement with preserved gray-white junction: a sign of reversible ischemia.

    abstract:BACKGROUND AND PURPOSE:Sulcal effacement with preserved underlying gray-white matter junction (isolated sulcal effacement [ISE]) in acute ischemic stroke may not represent irreversible parenchymal injury. We aimed to evaluate the frequency and significance of ISE in patients with large vessel occlusion acute ischemic s...

    journal_title:Stroke

    pub_type: 临床试验,杂志文章

    doi:10.1161/STROKEAHA.115.009304

    authors: Haussen DC,Lima A,Frankel M,Anderson A,Belagaje S,Nahab F,Rangaraju S,Nogueira RG

    更新日期:2015-06-01 00:00:00

  • Shape and volume of lacunar infarcts: a 3D MRI study in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.

    abstract:BACKGROUND AND PURPOSE:The shape and exact size of lacunar infarcts have been investigated only postmortem. Recent imaging techniques based on triangulation and connectivity can now be used for 3D segmentation of cerebral lesions. The shape and size of lacunar infarcts was investigated using these techniques in 10 cere...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.STR.0000185678.26296.38

    authors: Hervé D,Mangin JF,Molko N,Bousser MG,Chabriat H

    更新日期:2005-11-01 00:00:00

  • Detection of mitral valve abnormalities by carotid Doppler flow study: implications for the management of patients with cerebrovascular disease.

    abstract::Patients with symptoms of cerebral ischemia are often evaluated with non-invasive carotid artery testing. An abnormal carotid Doppler ultrasound frequency shift pattern of early systolic flutter (ESF) was demonstrated by auscultation and velocity wave form analysis in patients with normal carotid bifurcations. Ten of ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.16.6.977

    authors: Weinberger J,Goldman M

    更新日期:1985-11-01 00:00:00

  • Altered Fibrin Clot Properties in Patients With Cerebral Venous Sinus Thrombosis: Association With the Risk of Recurrence.

    abstract:BACKGROUND AND PURPOSE:Venous thromboembolism and ischemic stroke are associated with unfavorable fibrin clot structure and function. We hypothesized that denser fibrin networks displaying impaired lysability characterize patients with cerebral venous sinus thrombosis (CVST). METHODS:We assessed plasma fibrin clot pro...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.115.009528

    authors: Siudut J,Świat M,Undas A

    更新日期:2015-09-01 00:00:00

  • Vessel wall magnetic resonance imaging in acute ischemic stroke: effects of embolism and mechanical thrombectomy on the arterial wall.

    abstract:BACKGROUND AND PURPOSE:The aim of the study was to determine the effects of thromboembolism and mechanical thrombectomy on the vessel wall magnetic resonance imaging (VW-MRI) appearance of the intracranial arterial wall. METHODS:This was a cross-sectional study of consecutive patients with acute intracranial arterial ...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/STROKEAHA.114.005618

    authors: Power S,Matouk C,Casaubon LK,Silver FL,Krings T,Mikulis DJ,Mandell DM

    更新日期:2014-08-01 00:00:00

  • Estimated cost savings of increased use of intravenous tissue plasminogen activator for acute ischemic stroke in Canada.

    abstract:BACKGROUND AND PURPOSE:Intravenous tissue plasminogen activator (tPA) is an economically worthwhile but underused treatment option for acute ischemic stroke. We sought to identify the extent of tPA use in Canadian medical centers and the potential savings associated with increased use nationally and by province. METHO...

    journal_title:Stroke

    pub_type: 信件

    doi:10.1161/STROKEAHA.106.479477

    authors: Yip TR,Demaerschalk BM

    更新日期:2007-06-01 00:00:00

  • Role of platelet function in symptomatic cerebral vasospasm following aneurysmal subarachnoid hemorrhage.

    abstract::To evaluate the role of platelet function in the pathogenesis of cerebral vasospasm, we compared sequential changes of platelet aggregability and beta-thromboglobulin and thromboxane B2 concentrations in blood samples from the internal jugular and peripheral vein of 13 patients with aneurysmal subarachnoid hemorrhage....

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.22.7.854

    authors: Ohkuma H,Suzuki S,Kimura M,Sobata E

    更新日期:1991-07-01 00:00:00

  • Leukocyte rheology in recent stroke.

    abstract::Eighteen patients with recent ischemic stroke were compared with an equal number of matched controls. Standardized suspensions of red cells as well as of red and white cells were filtered in a new filtration apparatus capable of discriminating between cell deformability and filter occlusion. Results show that red cell...

    journal_title:Stroke

    pub_type: 杂志文章

    doi:10.1161/01.str.18.1.59

    authors: Ernst E,Matrai A,Paulsen F

    更新日期:1987-01-01 00:00:00