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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Local thrombolysis for acute ischemic stroke based on findings of diffusion and perfusion MRI

N Kitagawa1, M Morikawa, K Hayashi

  • 1Department of Neurosurgery, Nagasaki University school of Medicine, Nagasaki; Japan - naoki-k@net.nagasaki-u.ac.jp.

Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences
|July 29, 2010
PubMed
Abstract

Insights

Diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) help identify acute embolic stroke patients who benefit from thrombolytic therapy. Early imaging selection can prevent irreversible brain damage.

Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Acute embolic stroke in the internal carotid artery territory requires timely intervention.
  • Assessing cerebral perfusion and tissue integrity is crucial for treatment decisions.

Purpose of the Study:

  • To evaluate the utility of diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) in selecting patients for thrombolytic therapy in acute embolic stroke.
  • To correlate imaging findings with treatment outcomes.

Main Methods:

  • Studied 13 patients with acute embolic stroke within six hours of onset.
  • Utilized diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI).
  • Assessed for PWI/DWI mismatch and middle cerebral artery (MCA) occlusion.

Main Results:

  • Six patients showed a PWI/DWI mismatch and underwent thrombolytic therapy for MCA occlusion.
  • Three of these patients achieved complete reperfusion, preventing infarct expansion.
  • Seven patients without mismatch did not receive thrombolysis; one experienced spontaneous MCA reopening and subsequent hemorrhage.

Conclusions:

  • Combined DWI and PWI are valuable tools for selecting acute embolic stroke patients for thrombolytic therapy.
  • Identifying PWI/DWI mismatch aids in predicting treatment response and preventing ischemic damage.
  • Early imaging can guide therapeutic interventions and improve patient outcomes.

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