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Related Concept Videos

Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Brain Imaging01:14

Brain Imaging

Brain imaging technologies provide critical insights into both the structure and function of the human brain, enabling medical professionals and researchers to diagnose, study, and treat neurological disorders or psychiatric disorders more effectively.
These technologies include computerized axial tomography (CAT or CT scans), positron-emission tomography (PET scans),  magnetic resonance imaging (MRI),  functional magnetic resonance imaging (fMRI), and Transcranial Magnetic Stimulation (TMS).
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.

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Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli
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Brain imaging modality before systemic thrombolysis for ischemic stroke within three hours.

Takeshi Uenaka1, Yukihiro Yoneda, Shinji Yamamoto

  • 1Division of Neurology, Kobe Red Cross Hospital and Hyogo Emergency Medical Center, Chuo Ward, Kobe, Japan.

European Neurology
|September 8, 2010
PubMed
Summary
This summary is machine-generated.

Adding MRI/MRA to CT scans for ischemic stroke patients receiving IV-tPA did not change overall thrombolysis times but increased in-hospital delays. Clinical outcomes at 3 months were comparable between groups.

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Published on: November 26, 2013

Area of Science:

  • Neurology
  • Radiology
  • Emergency Medicine

Background:

  • Intravenous thrombolysis (IVT) with tissue plasminogen activator (tPA) is a critical treatment for acute ischemic stroke within 3 hours of onset.
  • In Japan, CT screening followed by MRI/MRA is common, balancing diagnostic accuracy with timely treatment initiation.

Purpose of the Study:

  • To evaluate the impact of imaging strategies (CT only vs. CT + MRI/MRA) on thrombolysis delays and clinical outcomes in ischemic stroke patients.
  • To assess the feasibility and consequences of incorporating MRI/MRA into the acute stroke imaging pathway.

Main Methods:

  • Retrospective analysis of 67 ischemic stroke patients receiving IVT within 3 hours.
  • Comparison of pre-hospital delay, door-to-needle time, and 3-month modified Rankin Scale scores between patients who underwent CT only versus CT + MRI/MRA.

Main Results:

  • 85% of patients received CT + MRI/MRA, while 15% had CT only.
  • Patients with CT + MRI/MRA had shorter pre-hospital delays but significantly longer door-to-needle times (90 vs. 57 minutes).
  • Overall time from stroke onset to thrombolysis and 3-month clinical outcomes were comparable between imaging groups.

Conclusions:

  • Initial CT screening with optional MRI/MRA is feasible for ischemic stroke patients.
  • The addition of MRI/MRA led to an approximate 30-minute in-hospital delay in tPA administration.
  • Further optimization is needed to mitigate in-hospital delays associated with advanced imaging to potentially improve clinical outcomes.