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Radiological Assessment of Ischemic Stroke

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Book cover Acute Ischemic Stroke

Abstract

Acute ischemic stroke (AIS) can be treatable if therapy is given early. In general, intravenous thrombolytic therapy should be initiated within 4.5 h of symptom onset, and expeditious revascularization is associated with better clinical outcome [1]. In the assessment of acute ischemic stroke, neuroimaging plays a critical role in determining patient care. Recent clinical trials [2–5] regarding patient selection mostly include radiological imaging criteria. The main goals of imaging in patients with symptoms of AIS are (1) to rule out hemorrhagic stroke, (2) to define the extent of the ischemic damage and to differentiate between the infarct core and the salvageable ischemic penumbra, and (3) to visualize the vessel status (arterial occlusion and collateral circulation). At present there is no consensus on a preferred imaging modality in patients presenting with AIS. The AHA guidelines recommend brain imaging with computed tomography (CT) or magnetic resonance imaging (MRI) in all suspected stroke [6]. Current radiological diagnostic strategies for this patient group are discussed in this chapter. Although positron emission tomography (PET) has been considered the gold standard for defining the ischemic core, penumbra, and benign oligemia, it is not a practical imaging modality in the routine, clinical, acute stroke setting. As such, attention has focused on the role of multimodal magnetic resonance imaging (MRI) and multimodal computed tomography (CT) for defining the infarct core and the penumbra.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 110-744, South Korea

    Chul-Ho Sohn MD, PhD

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  1. Chul-Ho Sohn MD, PhD
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Correspondence to Chul-Ho Sohn MD, PhD .

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  1. Department of Neurosurgery, Kyungpook National University Hospital, Daegu, Korea (Republic of)

    Jaechan Park

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Sohn, CH. (2017). Radiological Assessment of Ischemic Stroke. In: Park, J. (eds) Acute Ischemic Stroke. Springer, Singapore. https://doi.org/10.1007/978-981-10-0965-5_3

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  • DOI: https://doi.org/10.1007/978-981-10-0965-5_3

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