Abstract
The traditional thrust of diagnostic radiology has been in the evaluation of tissue structure and the changes in structure that may result from a variety of pathologies. However, with increasing sophistication and power of digital computers coupled with technological advances in imaging methods, it has become routinely possible to image organ function, and in particular vascular physiology, at the same time as providing traditional anatomical information. These developments have brought a wholly new dimension to the practice of neurology, neuroradiology and neurosurgery. We can now routinely investigate the fundamental changes underlying cerebrovascular disease; that is we can demonstrate vascular physiology as exemplified by bulk blood flow and parenchymal or tissue perfusion.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Alberts M. tPA in acute ischemic stroke-United States experience and issues for the future. Neurology 1998;51:S53–55.
Caplan L, Möhr J, Kistler P, al. e. Should thrombolytic therapy be the first-line treatment for acute ischemic stroke? New England Journal of Medicine 1997;337:1309–1310.
del Zoppo G, Poeck K, al e. Recombinant tissue plasminogen activator in acute thrombotic stroke. Ann Neurol 1992;32:78–86.
del Zoppo G, Higashida R, Furlan A, Pessin M, Rowley H, Gent M. PROACT: a phase II randomized trial of recombinant pro-urokinase by direct arterial delivery in acute middle cerebral artery stroke. Stroke 1998;29(1):4–11.
Hacke W, Zeumer H, Ferbert A, al. e. Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke 1988;19:1216–212.
Hacke W, Kaste M, Fieschi C, et a. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke: the European Cooperative Acute Stroke Study (ECASS). JAMA 1995;274:1017–1025.
National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group T. Tissueplas-minogen activator for acute ischemic stroke. New England Journal of Medicine 1995;333:1581–1587.
NINDS SSG. Effect of rt-PA on ischemic lesion size by computed tomography. Preliminary results from the NINDS rt-PA Stroke Trial. Stroke 1997;28:2109–2118.
von Kummer R, Allen K, Holle R, et a. Acute stroke: Usefulness of early CT findings before thromobolytic therapy. Radiology 1997;205:327–333.
Furlan A, Higashida R, Wechsler L, et al. Intra-arterial prourokinase for acute ischemic stroke. JAMA 1999;282:2003–2011.
von Kummer R, Holle R, Grzyska U, Hofmann E, et a. Interobserver agreement in assessing early CT signs of middle cerebral artery infarction. American Journal of Neuroradiology 1996;17:1743–1748.
Wardlaw J, Dorman P, Lewis S, Sandercock R. Can stroke physicians and neuroradiologists identify signs of early cerebral infarction on CT? J Neurol Neursosurg Psychiatry 1999;67:651–653.
Grotta J, Chiu D, Lu M, al e. Agreement and variability in the interpretation of early CT changes in stroke patients qualifying for intravenous rtPA therapy. Stroke 1999;30:1528–1533.
Hamberg LM, Hunter GJ, Kierstead D, Lo EH, Gonzalez RG, Wolf GL, Measurement of Cerebral Blood Volume with Subtraction Three-dimensional Functional CT, AJNR AM J Neuroradiol 17: 1861–1869,1996.
Hamberg LM, Salonen OL, Hunter GL, Vuorela J, Kaste M, Wolf GL, Determination of Perfusion Deficits in Ischemic Patients by Using First Pass CT, 80th Scientific Assembly and Annual Meeting, November, Volume 193 (P), Supplement to Radiology, p 123, Chicago 1994.
Hunter G J, Hamberg LM, Morris PP, Maynard K, Lo EH, Owen C, Debros FM, Choid IS, Tatter S, Gonzalez RG, Wolf GL, Ogilvy C, Demonstration of the cerebrovascular physiology of acute stroke using high resolution first pass slip-ring CT. Proceedings of the American Society of Neuroradiology, 33rd Annual Meeting, April 23–27, Chicago, p38, 1995
Hamberg LM, Hunter GJ, Halpern EF, Hoop B, Gazelle GS, Wolf GK, Quantitative High-Resolution Measurement of Cerebrovascular Physiology with Slip-Ring CT, AJNR Am J Neuroradiol 17:639–650, 1996.
Wildermuth S, Knauth M, Brandt T, Winter R, Sartor K, Hacke W. Role of CT Angiography in Patient Selection for Thrombolytic Therapy in Acute Hemispheric Stroke. Stroke 1998;29:935–938.
Knauth M, R. v, Jansen O, Hahnel S, Dorfler A, Sartor K. Potential of CT angiography in acute ischemic stroke [see comments]. American Journal of Neuroradiology 1997;18(6):1001–10.
Shrier D, Tanaka H, Numaguchi Y, Konno S, Patel U, Shibata D. CT angiography in the evaluation of acute stroke. American Journal of Neuroradiology 1997;18(6):1011-20. 21. Kendell B, Pullicono P. Intravascular contrast injection in ischemic lesions, II. Effect on prognosis. Neuroradiology 1980;19:241–243.
Farkas J, Lev M, Schwamm L, et al. The diagnostic value of CT angiography in hyperacute stroke. In: Stroke: Proceedings of the 23rd International Conference on Stroke and Cerebral Circulation, Orlando, FL 1998
Ponzo J, Hunter G, Hamburg L, et al. Evaluation of collateral circulation in acute stroke patients using CT angiography. In: Stroke: Proceedings of the 23rd International Conference on Stroke and Cerebral Circulation, Orlando, FL 1998
Barest G, Hunter G, Hamberg L, et al. Dynamic contrast enhanced helical CT improves conspicuity of acute cerebral ischemia. In: Proceedings of the 83nd Scientific Assembly and Annual Meeting of the Radiological Society of North America, (Hot topics), Chicago, IL 1997.
Lev M, Parkas J, Gemmete J, et al. Acute stroke: Improved nonenhanced CT detection-Benefits of soft-copy interpretation by using variable window width and center level settings. Radiology 1999;213:150–155.
Lev M, Parkas J, Gemmete J, et al. Improved CT detection of hyperacute stroke: the benefits of helical CT perfusion imaging and soft copy interpretation. In: Proceedings of the 84th Scientific Assembly and Annual Meeting of the Radiological Society of North America, Chicago, IL 1998.
Hunter GJ, Hamberg LM, Ponzo JA, et al. Assessment of cerebral perfusion and arterial anatomy in hyperacute stroke with three-dimensional functional CT: Early clinical results. American Journal of Neuroradiology 1998;19:29–37.
Lev M, Segal A, Farkas J, et al. CT perfusion imaging of hyperacute middle cerebral artery stroke predicts outcome of intraarterial thrombolytic treatment. In: Annual Meeting of the America Society of Neuroradiology, San Diego, CA 1999; 258–9.
Koroshetz WJ, Gonzalez RG. Imaging stroke in progress: magnetic resonance advances but computed tomography is poised for counterattack. Annals of Neurology 1999;46:556–558.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2003 Kluwer Academic/Plenum Publishers, New York
About this chapter
Cite this chapter
Hunter, G., Hamberg, L.M., Lev, M.H., Gonzales, R.G. (2003). Computed Tomography Angiography and Perfusion Imaging of Acute Stroke. In: Cerebral Blood Flow. Update in Intensive Care Medicine, vol 37. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-56036-1_12
Download citation
DOI: https://doi.org/10.1007/978-3-642-56036-1_12
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-42684-4
Online ISBN: 978-3-642-56036-1
eBook Packages: Springer Book Archive