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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...
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.
Transient Ischemic Attack l: Introduction01:26

Transient Ischemic Attack l: Introduction

A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...

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Updated: May 18, 2026

Optimization of the Longa Middle Cerebral Artery Occlusion Method for Complete Reperfusion
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Published on: November 22, 2024

Identifying and utilizing the ischemic penumbra.

Marc Fisher1, Birgul Bastan

  • 1Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA. fisherm@ummhc.org

Neurology
|September 26, 2012
PubMed
Summary
This summary is machine-generated.

The penumbra, brain tissue at risk of stroke, evolves based on cerebral blood flow (CBF) decline. Identifying penumbral tissue using imaging is crucial for guiding endovascular stroke therapy.

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Published on: October 23, 2020

Area of Science:

  • Neuroscience
  • Cerebrovascular Medicine
  • Medical Imaging

Background:

  • The ischemic penumbra represents brain tissue potentially salvageable after stroke.
  • Its evolution to irreversible injury is critically linked to cerebral blood flow (CBF) reduction.
  • Defining penumbral tissue requires understanding specific CBF thresholds.

Purpose of the Study:

  • To review the basic science of the penumbral concept.
  • To explore methods for identifying penumbral tissue using various imaging modalities.
  • To establish the foundation for understanding its clinical application in endovascular stroke therapy.

Main Methods:

  • Review of scientific literature on the penumbral concept.
  • Analysis of imaging modalities including PET, MRI, and CT.
  • Examination of data from animal models and human studies.

Main Results:

  • The penumbra is characterized by reduced CBF, initially preserving ionic homeostasis.
  • Specific CBF ranges (10-15 mL/100 g/min and ~25 mL/100 g/min) help identify penumbral tissue.
  • The ischemic core has CBF below the lower threshold, indicating irreversible injury.

Conclusions:

  • Accurate identification of the penumbra is essential for patient triage in endovascular stroke therapy.
  • Imaging techniques are vital for delineating penumbral tissue.
  • Further understanding of the penumbral concept aids in optimizing stroke treatment strategies.