Ischemic core and penumbra in human stroke

Stroke

Volumn 30, Issue 1, 1999, Pages 93-99

  Kaufmann, Anthony M ^a   Firlik, Andrew D ^b   Fukui, Melanie B ^b   Wechsler, Lawrence R ^b   Jungries, Charles A ^b   Yonas, Howard ^b  

^a UNIVERSITY OF CALGARY   (Canada)

^b UNIVERSITY OF PITTSBURGH   (United States)

Author keywords

Cerebral blood flow; Cerebral infarction; Cerebral ischemia; Penumbra; Tomography, emission computed

Indexed keywords

ADULT; AGED; ARTICLE; BRAIN BLOOD FLOW; BRAIN INFARCTION; BRAIN ISCHEMIA; CLINICAL ARTICLE; COMPUTER ASSISTED TOMOGRAPHY; CONTROLLED STUDY; DIAGNOSTIC IMAGING; FEMALE; HUMAN; ISCHEMIA; MALE; PRIORITY JOURNAL; STROKE; THROMBOEMBOLISM; TREATMENT OUTCOME;

EID: 0032908245     PISSN: 00392499     EISSN: None     Source Type: Journal    
DOI: 10.1161/01.STR.30.1.93     Document Type: Article

References (44)

1. Jones TH, Morawetz RB, Crowell RM, Marcoux FW, FitzGibbon SJ, DeGirolami U, Ojemann RG. Thresholds of focal cerebral ischemia in awake monkeys. J Neurosurg. 1981;54:773-782.
2. Donnan GA, Davis SM, Chambers BR, Gates PC, Hankey GJ, McNeil JJ, Rosen D, Stewart-Wynne EG, Tuck RR. Trials of streptokinase in severe acute ischaemic stroke. Lancet. 1995;345:578-579. Letter and comment.
3. National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333:1581-1587.
4. Hacke W, Kaste M, Fieschi C, Toni D, Lesaffre E, von Kummer R, Boysen G, Hoxter G, Mahagne MH, Hennerici M. Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke: the European Cooperative Acute Stroke Study (ECASS). JAMA. 1995;274:1017-1025.
5. Fisher M. Characterizing the target of acute stroke therapy. Stroke. 1997; 28:866-872.
6. Mohr JP, Biller J, Hilal SK, Yuh WT, Tatemichi TK, Hedges S, Tali E. Nguyen H, Mun I, Adams HPJ. Magnetic resonance versus computed tomographic imaging in acute stroke. Stroke. 1995;26:807-812.
7. Dromerick AW, Reding MJ. Functional outcome for patients with hemiparesis, hemihypesthesia, and hemianopsia: does lesion location matter? Stroke 1995;26:2023-2026.
8. Mohr JP. Some clinical aspects of acute stroke. Stroke. 1997;28: 1835-1839. Excellence in Clinical Stroke Award Lecture.
9. DeGirolami U, Crowell RM, Marcoux FW. Selective necrosis and total necrosis in focal cerebral ischemia: neuropathologic observations on experimental middle cerebral artery occlusion in the macaque monkey. J Neuropathol Exp Neurol. 1984;43:57-71.
10. Weinstein PR, Anderson GG, Telles DA. Neurological deficit and cerebral infarction after temporary middle cerebral artery occlusion in unanesthetized cats. Stroke. 1986;17:318-324.
11. Kaplan B, Brint S, Tanabe J, Jacewicz M, Wang XJ, Pulsinelli W. Temporal thresholds for neocortical infarction in rats subjected to reversible focal cerebral ischemia. Stroke. 1991;22:1032-1039.
12. Heiss WD, Huber M, Fink GR, Herholz K, Pietrzyk U, Wagner R, Wienhold K. Progressive derangement of periinfarct viable tissue in ischemic stroke. J Cereb Blood Flow Metab. 1992;12:193-203.
13. Pappata S, Fiorelli M, Rommel T. Hartmann A. Dettmers C, Yamaguchi T, Chabriat T, Poline JB, Crouzel C, DiGiamberardino L. PET study of changes in local brain hemodynamics and oxygen metabolism after uni-lateral middle cerebral artery occlusion in baboons. J Cereb Blood Flow Metab. 1993;13:416-424.
14. Touzani O, Young AR, Derlon JM, Beaudouin V, Marchal G, Rioux P, Mezenge F, Baron JC, Mackenzie ET. Sequential studies of severely hypometabolic tissue volumes after permanent middle cerebral artery occlusion: a positron emission tomographic investigation in anesthetized baboons. Stroke. 1995;26:2112-2119.
15. Astrup J, Siesjo BK, Symon L. Thresholds in cerebral ischemia: the ischemic penumbra. Stroke. 1981;12:723-725.
16. + at critical levels of brain ischemia. Stroke. 1977;8:51-57.
17. Siesjo BK. Pathophysiology and treatment of focal cerebral ischemia. 1: pathophysiology. J Neurosurg. 1992;77:169-184.
18. Lassen NA, Fieschi C, Lenzi G. Ischemic penumbra and neuronal death: comments on the therapeutic window in acute stroke with particular reference to thrombolytic therapy. Cerebrovasc Dis. 1991;1(suppl 1):32-35.
19. Hossmann KA. Viability thresholds and the penumbra of focal ischemia [see comments]. Ann Neurol. 1994;36:557-565.
20. Ginsberg MD, Pulsinelli W. The ischemic penumbra, injury thresholds and therapeutic time window for acute stroke. Ann Neurol. 1994;36: 553-554.
21. Hakim AM. The cerebral ischemic penumbra. Can J Neurol Sci. 1987; 14:557-559.
22. Baron JC, von Kummer R, del Zuppo G. Treatment of acute ischemic stroke: challenging the concept of a rigid and universal time window. Stroke. 1995;26:2219-2221. Editorial.
23. Furlan M, Marchal G, Ravenel N, Rioux P, Courtheoux P, Viader F, Derkn JM, Baron JC. The mechanisms of early neurological recovery after acute ischemic stroke (AIS). Neurology. 1994;44(suppl 2):A407-A408.
24. Marchal G, Beaudouin V, Furlan M, Lochon P, Onfroy MC, Petit-Taboue MC, Derlon JM, Baron JC. Demonstration of metabolically deteriorating ischemic tissue within the eventually infarcted volume by pixel integration-threshold analysis: an acute and follow-up PET study. J Cereb Blood Flow Metab. 1993;13(suppl 1):S274.
25. Marchal G, Serrati C, Rioux P, Petit-Taboue MC, Viader F, de la Sayette, LeDoze F, Lochon P, Derkn JM, Orgogozo JM, Baron JC. PET imaging of cerebral perfusion and oxygen consumption in acute ischemic stroke. Lancet. 1993;341:925-927.
26. Marchal G, Rioux P, Serrati C, Furlan M, Derlon JM, Viader F, Baron JC. Value of acute-stage positron emission tomography in predicting neurological outcome after ischemic stroke: further assessment. Stroke. 1995; 26:524-525. Letter.
27. Wise RJ, Bemardi S, Frackowiak RS, Legg NJ, Jones T. Serial observations on the pathophysiology of acute stroke: the transition from ischemia to infarction as reflected in regional oxygen extraction. Brain. 1983; 106:197-222.
28. Minematsu K, Yamaguchi T, Omae T. Spectacular shrinking deficit. Neurology. 1992;42:157-162.
29. Marchal G, Beaudouin V, Rioux P, de la Sayette, Le Doze F, Viader F, Derlon JM, Baron JC. Prolonged persistence of substantial volumes of potentially viable brain tissue after stroke: a correlative PET-CT study with voxel-based data analysis [see comments]. Stroke. 1996;27: 599-606.
30. Touho H, Karasawa J. Evaluation of time-dependent thresholds of cerebral blood flow and transit time during the acute stage of cerebral embolism: a retrospective study. Surg Neurol. 1996;46:135-145.
31. Tamura A, Asano T, Sano K. Correlation between rCBF and histological changes following temporary middle cerebral artery occlusion. Stroke. 1980;11:487-493.
32. Carter LP, Yamagata S, Erspamer R. Time limits of reversible cortical ischemia. Neurosurgery. 1983;12:620-623.
33. Crowell RM, Olsson Y, Klatzo I, Ommaya A. Temporary occlusion of the middle cerebral artery in the monkey: clinical and pathological observations. Stroke. 1970;1:439-448.
34. Powers WJ, Grubb RLJ, Darriet D, Raichle ME. Cerebral blood flow and cerebral metabolic rate of oxygen requirements for cerebral function and viability in humans. J Cereb Blood Flow Metab. 1985;5:600-608.
35. Pulsinelli W. Pathophysiology of acute cerebral ischemia. Lancet. 1992; 359:533-536.
36. Yonas H, Johnson DW, Pindzola RR. Xenon-enhanced CT of cerebral blood flow. Sci Am 1995;2:58-67.
37. 14C]iodoantipyrine for normal and low cerebral blood flow states in baboons. Stroke. 1990;21:751-757.
38. DeWitt DS, Fatouros PP, Wist AO, Stewart LM, Kontos HA, Hall JA, Kishore PR, Keenan RL, Marmarai A. Stable xenon versus radiolabeled microsphere cerebral blood flow measurements in baboons. Stroke. 1989; 20:1716-1723.
39. Fatouros PP, Wist AO, Kishore PR, DeWitt DS, Hall JA, Keenan RL, Stewart LM, Marmarai A, Choi SC, Kontos HA. Xenon/computed tomography cerebral blood flow measurements: methods and accuracy. Invest Radiol. 1987;22:705-712.
40. Yonas H, Darby JM, Marks EC, Durham SR, Maxwell C. CBF measured by Xe-CT: approach to analysis and normal values. J Cereb Blood Flow Metab. 1991;11:716-725.
41. Yonas H, Gur D, Claassen D, Wolfson SKJ, Moossy J. Stable xenon enhanced computed tomography in the study of clinical and pathologic correlates of focal ischemia in baboons. Stroke. 1988;19:228-238.
42. Yonas H, Gur D, Claassen D, Wolfson SKJ, Moossy J. Stable xenon-enhanced CT measurement of cerebral blood flow in reversible focal ischemia in baboons. J Neurosurg. 1990;73:266-273.
43. Baron JC, Rougemont D, Bousser MG, Lebru-Grandie P, Iba-Zizen MT, Chiras J. Local CBF, oxygen extraction fraction (OEF) and CMRO: prognostic value in recent supratentorial infarction in humans. J Cereb Blood Flow Metab. 1983;3(suppl 1):1-2.
44. Ackerman RH, Lev MH, Mackay BC, Katz PM, Babikian VL, Alpert NM, Correia JA, Panagos PD, Senda M. PET studies in acute stroke: findings and relevance to therapy. J Cereb Blood Flow Metab. 1989; 9(suppl 1):S359.