CT perfusion hypervolemia: brain ischemia or stroke mimic?

  • Anna KoopmanEmail author
  • Frank-Erik de Leeuw
  • Frederick Meijer
Letter to the Editor

Dear Editor-in-Chief,

In acute ischemic stroke, diagnostic imaging is crucial to identify patients for possible revascularization therapy. Estimation of brain tissue viability becomes more and more relevant in patient selection for intra-arterial thrombectomy, especially as the time window has been extended up to 24 h after onset of symptoms in selected cases [1]. Therefore, clinical application of CT perfusion is increasing.

Early signs of cerebral ischemia are commonly difficult to detect on non-contrast CT. However, a cerebral perfusion deficit can be easily visualized on CT perfusion, thus increasing confidence about the diagnosis of ischemic stroke [2, 3]. Furthermore, CT perfusion can aid in the detection of intracranial vessel occlusions [4].

Tissue viability estimation on CT perfusion is challenging and prone to error, as multiple pathophysiological and technical factors are of influence [5]. Assessment of infarct core and penumbra area extent might be altered by the scanning...



No funding was received for this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Radiology and Nuclear MedicineRadboud University Medical CenterNijmegenThe Netherlands
  2. 2.Donders Institute for Brain, Cognition and Behaviour, Center for Cognitive Neuroscience, Department of NeurologyRadboud University Medical CenterNijmegenthe Netherlands

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