Advanced neuroimaging in acute ischemic stroke: extending the time window for treatment

Abstract

<jats:p>Early treatment of ischemic stroke with thrombolytics is associated with improved outcomes, but few stroke patients receive thrombolytic treatment in part due to the 3-hour time window. Advances in neuroimaging may help to aid in the selection of patients who may still benefit from thrombolytic treatment beyond conventional time-based guidelines. In this article the authors review the available literature in support of using advanced neuroimaging to select patients for treatment beyond the 3-hour time window cutoff and explore potential applications and limitations of perfusion imaging in the treatment of acute ischemic stroke.</jats:p>

Mapping of oxygen by imaging lipids relaxation enhancement: A potential sensitive endogenous MRI contrast to map variations in tissue oxygenation

“…Mapping brain tissue oxygenation shortly after acute ischemic stroke may be crucial in selecting patients who may still benefit from thrombolytic treatment beyond conventional time‐based guidelines . In this context, it seems mandatory to explore potential applications and limitations of oxygenation/perfusion mapping techniques in patient triage and patient eligibility for thrombolytic therapy in acute ischemic stroke . It is therefore useful to establish the potential relevance of MOBILE imaging in a stroke model as a complementary tool to the classic imaging protocol currently used to image acute or chronic strokes.…”

The Protective and Reparative Role of Colony-Stimulating Factors in the Brain with Cerebral Ischemia/Reperfusion Injury

“…Reperfusion therapy must be administered within a narrow window of time, for instance, intravenous tissue plasminogen activator (tPA) must be given up to 4.5 h after symptom onset. Therefore, this time restriction disqualifies the majority of stroke patients admitted beyond this narrow time window (around 85%), thereby drastically limiting the eligible population [3-5].…”