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Related Experiment Videos

Time is brain: is MRI the clock?

Tobias Neumann-Haefelin1, Helmuth Steinmetz

  • 1Department of Neurology, Goethe-University Frankfurt, Frankfurt, Germany. tnh@rz.uni-frankfurt.de

Current Opinion in Neurology
|July 11, 2007
PubMed
Summary
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The mismatch concept, using advanced MRI, helps identify acute stroke patients who benefit from reperfusion therapies, especially those presenting later. Further standardization is needed for broader clinical adoption.

Area of Science:

  • Neuroimaging
  • Stroke Medicine
  • Radiology

Background:

  • Magnetic Resonance Imaging (MRI) is becoming the primary imaging tool for acute stroke.
  • MRI enables treatment decisions based on individual pathophysiology, moving beyond strict time windows.

Purpose of the Study:

  • To evaluate the role of MRI in acute stroke management.
  • To assess the utility of the perfusion-diffusion mismatch concept in guiding reperfusion therapies.
  • To identify MRI-derived risk factors for intracerebral hemorrhage after thrombolysis.

Main Methods:

  • Review of prospective trials and PET studies.
  • Analysis of perfusion-diffusion mismatch in acute stroke.
  • Investigation of MRI parameters predicting hemorrhagic transformation.

Related Experiment Videos

Main Results:

  • Perfusion-diffusion mismatch identifies patients who benefit from reperfusion therapies, particularly those presenting beyond 3 hours.
  • Disturbed diffusion on MRI may indicate irreversible tissue damage but can also represent viable tissue.
  • Severe ischemia, blood-brain barrier damage, and small-vessel disease on MRI are risk factors for intracerebral hemorrhage.

Conclusions:

  • The mismatch concept is a valid method for selecting patients for recanalization therapies based on current trial data.
  • Standardized definitions and further refinement of the mismatch concept are necessary for widespread clinical implementation.