Imaging selection for reperfusion therapy in acute ischemic stroke.

Area of Science:

• Neurology
• Radiology
• Emergency Medicine

Background:

• Neuroimaging plays a critical role in the immediate assessment of patients presenting with suspected acute stroke.
• Accurate diagnosis is essential to differentiate true strokes from stroke mimics and to determine appropriate treatment pathways.

Purpose of the Study:

• To outline the essential role of neuroimaging in the acute stroke workflow.
• To detail the utility of various neuroimaging modalities in guiding reperfusion therapies.

Main Methods:

• Review of current neuroimaging techniques used in acute stroke evaluation.
• Discussion of criteria for selecting patients for intravenous thrombolysis and endovascular therapy.

Main Results:

• Computed tomography (CT) and magnetic resonance imaging (MRI) are fundamental for diagnosis and triage.
• Advanced imaging like CT-angiography, MR-angiography, CT-perfusion, and MR-perfusion provide critical data for treatment decisions.
• Key criteria for endovascular therapy include accessible occlusion, small infarct core, and significant penumbra.

Conclusions:

• Neuroimaging is indispensable for the timely and effective management of acute stroke.
• Advanced neuroimaging techniques optimize patient selection for reperfusion therapies, improving outcomes.