Encyclopedia of Clinical Neuropsychology

2018 Edition
| Editors: Jeffrey S. Kreutzer, John DeLuca, Bruce Caplan

Ischemic Penumbra

  • Helen M. GenovaEmail author
  • Nuri Erkut Kucukboyaci
Reference work entry
DOI: https://doi.org/10.1007/978-3-319-57111-9_1047

Definition

Ischemic penumbra refers to a rim of tissue lying just outside the core ischemic region (area most severely damaged by stroke or ischemic event). Within the core ischemic region, blood and oxygen flow is severely diminished, resulting in neuronal death. However, in the ischemic penumbra, cells are viable for a short amount of time. The penumbra receives its limited blood flow from the collateral arteries of the occluded vascular tree. Studies examining how long penumbral tissue remains viable have reported anywhere from 6 h to 3 days. However, it has been shown that once the subacute phase of the stroke sets in (6–11 days), the untreated penumbral area will succumb to necrosis (cell death). This is due to the fact that the demand for oxygen is too great for the occluded vascular tree to supply.

Importance

The absence of unequivocal signs of tissue death in the ischemic penumbra makes it a target for acute pharmacologic intervention following stroke.

Detection

Ischemic...

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References and Readings

  1. Astrup, J., Siesjo, B. K., & Symon, L. (1981). Thresholds in cerebral ischemia – The ischemic penumbra. Stroke, 12, 723–725.PubMedCrossRefGoogle Scholar
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  3. Heiss, W. D. (2011). The ischemic penumbra: Correlates in imaging and implications for treatment of ischemic stroke. The Johann Jacob Wepfer award 2011. Cerebrovascular Diseases, 32(4), 307–320.  https://doi.org/10.1159/000330462. Epub 2011 Sep 15. Review. PubMed PMID: 21921593.CrossRefPubMedGoogle Scholar
  4. Kwiatkowski, T. G., Libman, R. B., Frankel, M., Tilley, B. C., Morgenstern, L. B., Lu, M., et al. (1999). Effects of tissue plasminogen activator for acute ischemic stroke at one year. National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator Stroke Study Group. New England Journal of Medicine, 340(23), 1781–1787.PubMedCrossRefGoogle Scholar
  5. Wardlaw, J. M., Murray, V., Berge, E., del Zoppo, G. J. (2014). Thrombolysis for acute ischaemic stroke. Cochrane Database of Systematic Reviews (7), CD000213.  https://doi.org/10.1002/14651858.CD000213.pub3. Review. PubMed PMID: 25072528; PubMed Central PMCID: PMC4153726.

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Neuropsychology and Neuroscience LaboratoryKessler Foundation Research CenterWest OrangeUSA
  2. 2.Clinical PsychologyRusk Institute – NYU Langone HealthNew YorkUSA