Imaging of Ischemic Stroke

Michelle Lin, David S. Liebeskind

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

Purpose of Review: This article provides an overview of cerebrovascular hemodynamics, acute stroke pathophysiology, and collateral circulation, which are pivotal in the modern imaging of ischemic stroke that guides the care of the patient with stroke. Recent Findings: Neuroimaging provides extensive information on the brain and vascular health. Multimodal CT and MRI delineate the hemodynamics of ischemic stroke that may be used to guide treatment decisions and prognosticate regarding expected outcomes. Mismatch imaging with either CT or MRI may identify patients with salvageable regions who are at risk and likely to benefit from reperfusion therapy, even if they are outside the standard time window. Imaging of collateral circulation and determination of collateral grade may predict greater reperfusion, lower hemorrhage risk, and better functional outcome. Current neuroimaging technology also enables the identification of patients at high risk of hemorrhagic transformation or those who may be harmed by treatment or unlikely to benefit from it. Summary: This article reviews the use and impact of imaging for the patient with ischemic stroke, emphasizing how imaging builds upon clinical evaluation to establish diagnosis or etiology, reveal key pathophysiology, and guide therapeutic decisions.

Original languageEnglish (US)
Pages (from-to)1399-1423
Number of pages25
JournalCONTINUUM Lifelong Learning in Neurology
Volume22
Issue number5
DOIs
StatePublished - Oct 1 2016
Externally publishedYes

Fingerprint

Stroke
Collateral Circulation
Neuroimaging
Reperfusion
Hemodynamics
Therapeutics
Blood Vessels
Patient Care
Hemorrhage
Technology
Health
Brain

ASJC Scopus subject areas

  • Clinical Neurology
  • Genetics(clinical)

Cite this

Imaging of Ischemic Stroke. / Lin, Michelle; Liebeskind, David S.

In: CONTINUUM Lifelong Learning in Neurology, Vol. 22, No. 5, 01.10.2016, p. 1399-1423.

Research output: Contribution to journalReview article

Lin, Michelle ; Liebeskind, David S. / Imaging of Ischemic Stroke. In: CONTINUUM Lifelong Learning in Neurology. 2016 ; Vol. 22, No. 5. pp. 1399-1423.
@article{548321fd3bc94340b3fd70dbee61f256,
title = "Imaging of Ischemic Stroke",
abstract = "Purpose of Review: This article provides an overview of cerebrovascular hemodynamics, acute stroke pathophysiology, and collateral circulation, which are pivotal in the modern imaging of ischemic stroke that guides the care of the patient with stroke. Recent Findings: Neuroimaging provides extensive information on the brain and vascular health. Multimodal CT and MRI delineate the hemodynamics of ischemic stroke that may be used to guide treatment decisions and prognosticate regarding expected outcomes. Mismatch imaging with either CT or MRI may identify patients with salvageable regions who are at risk and likely to benefit from reperfusion therapy, even if they are outside the standard time window. Imaging of collateral circulation and determination of collateral grade may predict greater reperfusion, lower hemorrhage risk, and better functional outcome. Current neuroimaging technology also enables the identification of patients at high risk of hemorrhagic transformation or those who may be harmed by treatment or unlikely to benefit from it. Summary: This article reviews the use and impact of imaging for the patient with ischemic stroke, emphasizing how imaging builds upon clinical evaluation to establish diagnosis or etiology, reveal key pathophysiology, and guide therapeutic decisions.",
author = "Michelle Lin and Liebeskind, {David S.}",
year = "2016",
month = "10",
day = "1",
doi = "10.1212/CON.0000000000000376",
language = "English (US)",
volume = "22",
pages = "1399--1423",
journal = "Continuum (Minneapolis, Minn.)",
issn = "1080-2371",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Imaging of Ischemic Stroke

AU - Lin, Michelle

AU - Liebeskind, David S.

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Purpose of Review: This article provides an overview of cerebrovascular hemodynamics, acute stroke pathophysiology, and collateral circulation, which are pivotal in the modern imaging of ischemic stroke that guides the care of the patient with stroke. Recent Findings: Neuroimaging provides extensive information on the brain and vascular health. Multimodal CT and MRI delineate the hemodynamics of ischemic stroke that may be used to guide treatment decisions and prognosticate regarding expected outcomes. Mismatch imaging with either CT or MRI may identify patients with salvageable regions who are at risk and likely to benefit from reperfusion therapy, even if they are outside the standard time window. Imaging of collateral circulation and determination of collateral grade may predict greater reperfusion, lower hemorrhage risk, and better functional outcome. Current neuroimaging technology also enables the identification of patients at high risk of hemorrhagic transformation or those who may be harmed by treatment or unlikely to benefit from it. Summary: This article reviews the use and impact of imaging for the patient with ischemic stroke, emphasizing how imaging builds upon clinical evaluation to establish diagnosis or etiology, reveal key pathophysiology, and guide therapeutic decisions.

AB - Purpose of Review: This article provides an overview of cerebrovascular hemodynamics, acute stroke pathophysiology, and collateral circulation, which are pivotal in the modern imaging of ischemic stroke that guides the care of the patient with stroke. Recent Findings: Neuroimaging provides extensive information on the brain and vascular health. Multimodal CT and MRI delineate the hemodynamics of ischemic stroke that may be used to guide treatment decisions and prognosticate regarding expected outcomes. Mismatch imaging with either CT or MRI may identify patients with salvageable regions who are at risk and likely to benefit from reperfusion therapy, even if they are outside the standard time window. Imaging of collateral circulation and determination of collateral grade may predict greater reperfusion, lower hemorrhage risk, and better functional outcome. Current neuroimaging technology also enables the identification of patients at high risk of hemorrhagic transformation or those who may be harmed by treatment or unlikely to benefit from it. Summary: This article reviews the use and impact of imaging for the patient with ischemic stroke, emphasizing how imaging builds upon clinical evaluation to establish diagnosis or etiology, reveal key pathophysiology, and guide therapeutic decisions.

UR - http://www.scopus.com/inward/record.url?scp=84990250724&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84990250724&partnerID=8YFLogxK

U2 - 10.1212/CON.0000000000000376

DO - 10.1212/CON.0000000000000376

M3 - Review article

C2 - 27740982

AN - SCOPUS:84990250724

VL - 22

SP - 1399

EP - 1423

JO - Continuum (Minneapolis, Minn.)

JF - Continuum (Minneapolis, Minn.)

SN - 1080-2371

IS - 5

ER -