NDLI: Perfusion/Diffusion Mismatch Is Valid and Should Be Used for Selecting Delayed Interventions

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Translational Stroke Research : Volume 3, Issue 1, March 2012

Translational Stroke Research : Volume 2

Translational Stroke Research : Volume 1

Perfusion/Diffusion Mismatch Is Valid and Should Be Used for Selecting Delayed Interventions

Content Provider	Springer Nature Link
Author	Davis, Stephen Campbell, Bruce Christensen, Soren Ma, Henry Desmond, Patricia Parsons, Mark Levi, Christopher Bladin, Christopher Barber, P. Alan Donnan, Geoffrey
Copyright Year	2012
Abstract	The mismatch between a larger perfusion lesion and smaller diffusion lesion on magnetic resonance imaging is a validated signal of the ischemic penumbra, namely the region at risk in acute ischemic stroke that is critically hypoperfused and the target of reperfusion therapies. Clinical trials have shown strong correlations between reperfusion in mismatch patients and improved clinical outcomes. Attenuation of infarct growth is associated with reperfusion and corresponding clinical gains. Using computed tomography perfusion, the mismatch between relative cerebral blood flow or cerebral blood volume and perfusion delay is a comparable penumbral marker. Automated techniques allow rapid quantitative assessment of mismatch with thresholding to exclude benign oligemia. The penumbra is often present beyond the current 4.5-h time window, defined for the use of intravenous tPA. Treatment beyond this time point remains investigational. Although the efficacy of thrombolysis in mismatch patients requires further validation in randomized trials, there is now sufficient evidence to recommend that advanced neuroimaging of mismatch should be used for selection of delayed therapies in phase 3 trials.
Starting Page	188
Ending Page	197
Page Count	10
File Format	PDF
ISSN	18684483
Journal	Translational Stroke Research
Volume Number	3
Issue Number	2
e-ISSN	1868601X
Language	English
Publisher	Springer-Verlag
Publisher Date	2012-04-18
Publisher Place	New York
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	MRI Mismatch Ischemic penumbra Stroke Therapy Vascular Surgery Neurosurgery Cardiology Neurology Neurosciences
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Neuroscience Neurology (clinical)

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Perfusion/Diffusion Mismatch Is Valid and Should Be Used for Selecting Delayed Interventions

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