Clinical review: Imaging in ischaemic stroke - Implications for acute management

Critical Care

Volumn 11, Issue 5, 2007, Pages

  Moustafa, Ramez Reda ^a   Baron, Jean Claude ^a  

^a UNIVERSITY OF CAMBRIDGE   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

FIBRINOLYTIC AGENT;

BRAIN DECOMPRESSION; BRAIN EDEMA; BRAIN HEMORRHAGE; BRAIN INFARCTION; CEREBROVASCULAR ACCIDENT; CLINICAL DECISION MAKING; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; COMPUTER ASSISTED TOMOGRAPHY; DIAGNOSTIC ACCURACY; DIFFUSION WEIGHTED IMAGING; HUMAN; IMAGE ANALYSIS; INDUCED HYPOTHERMIA; INTERMETHOD COMPARISON; MAGNETIC RESONANCE ANGIOGRAPHY; NEUROIMAGING; NEUROPROTECTION; OXYGEN THERAPY; PATHOPHYSIOLOGY; PATIENT SELECTION; PERFUSION WEIGHTED IMAGING; POSITRON EMISSION TOMOGRAPHY; PRIORITY JOURNAL; REVIEW; RISK BENEFIT ANALYSIS; SENSITIVITY AND SPECIFICITY; STROKE PATIENT; THROMBUS; TREATMENT INDICATION; ACUTE DISEASE; FIBRINOLYTIC THERAPY; INTENSIVE CARE; METHODOLOGY; STROKE;

ACUTE DISEASE; CRITICAL CARE; HUMANS; MAGNETIC RESONANCE ANGIOGRAPHY; SENSITIVITY AND SPECIFICITY; STROKE; THROMBOLYTIC THERAPY; TOMOGRAPHY, X-RAY COMPUTED;

EID: 44449160095     PISSN: 13648535     EISSN: 1466609X     Source Type: Journal    
DOI: 10.1186/cc5973     Document Type: Review

References (108)

1. Astrup J Siesjo BK Symon L Thresholds in cerebral ischemia - the ischemic penumbra Stroke 1981, 12:723-725. 6272455
2. Marchal G Benali K Iglesias S Viader F Derlon JM Baron JC Voxel-based mapping of irreversible ischaemic damage with PET in acute stroke Brain 1999, 122(Pt 12):2387-2400. 10.1093/brain/122.12.2387 10581231
3. Baron JC von Kummer R del Zoppo GJ Treatment of acute ischemic stroke. Challenging the concept of a rigid and universal time window Stroke 1995, 26:2219-2221. 7491639
4. Baron JC Mapping the ischaemic penumbra with PET: Implications for acute stroke treatment Cerebrovasc Dis 1999, 9:193-201. 10.1159/000015955 10393405
5. Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group N Engl J Med 1995, 333:1581-1587. 10.1056/NEJM199512143332401 7477192
6. Hacke W Kaste M Fieschi C von Kummer R Davalos A Meier D Larrue V Bluhmki E Davis S Donnan G et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Second European-Australasian Acute Stroke Study Investigators Lancet 1998, 352:1245-1251. 10.1016/S0140-6736(98)08020-9 9788453
7. Barber PA Demchuk AM Zhang J Buchan AM Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group. Alberta Stroke Programme Early CT Score Lancet 2000, 355:1670-1674. 10.1016/S0140-6736(00)02237-6 10905241
8. Grotta JC Chiu D Lu M Patel S Levine SR Tilley BC Brott TG Haley EC Jr Lyden PD Kothari R et al. Agreement and variability in the interpretation of early CT changes in stroke patients qualifying for intravenous rtPA therapy Stroke 1999, 30:1528-1533. 10436095
9. Kucinski T Majumder A Knab R Naumann D Fiehler J Vaterlein O Eckert B Rother J Zeumer H Cerebral perfusion impairment correlates with the decrease of CT density in acute ischaemic stroke Neuroradiology 2004, 46:716-722. 10.1007/s00234-004-1226-y 15221155
10. von Kummer R Bourquain H Bastianello S Bozzao L Manelfe C Meier D Hacke W Early prediction of irreversible brain damage after ischemic stroke at CT Radiology 2001, 219:95-100. 11274542
11. Na DG Kim EY Ryoo JW Lee KH Roh HG Kim SS Song IC Chang KH CT sign of brain swelling without concomitant parenchymal hypoattenuation: comparison with diffusion - and perfusion-weighted MR imaging Radiology 2005, 235:992-998. 10.1148/radiol.2353040571 15860675
12. Coutts SB Demchuk AM Barber PA Hu WY Simon JE Buchan AM Hill MD Interobserver variation of ASPECTS in real time Stroke 2004, 35:e103-e105. 10.1161/01.STR.0000127082.19473.45 15073381
13. Patel SC Levine SR Tilley BC Grotta JC Lu M Frankel M Haley EC Jr Brott TG Broderick JP Horowitz S Lack of clinical significance of early ischemic changes on computed tomography in acute stroke JAMA 2001, 286:2830-2838. 10.1001/jama.286.22.2830 11735758
14. Butcher KS Lee SB Parsons MW Allport L Fink J Tress B Donnan G Davis SM Differential prognosis of isolated cortical swelling and hypoattenuation on CT in acute stroke Stroke 2007, 38:941-947. 10.1161/ 01.STR.0000258099.69995.b6 17272776
15. Leary MC Kidwell CS Villablanca JP Starkman S Jahan R Duckwiler GR Gobin YP Sykes S Gough KJ Ferguson K Validation of computed tomographic middle cerebral artery 'dot' sign: An angiographic correlation study Stroke 2003, 34:2636-2640. 10.1161/01.STR.0000092123.00938.83 14593125
16. Barber PA Demchuk AM Hill MD Pexman JH Hudon ME Frayne R Buchan AM The probability of middle cerebral artery MRA flow signal abnormality with quantified CT ischaemic change: Targets for future therapeutic studies J Neurol Neurosurg Psychiatry 2004, 75:1426-1430. 10.1136/jnnp.2003.029389 15377690
17. Kirchhof K Welzel T Mecke C Zoubaa S Sartor K Differentiation of white, mixed, and red thrombi: Value of CT in estimation of the prognosis of thrombolysis phantom study Radiology 2003, 228:126-130. 10.1148/ radiol.2273020530 12728185
18. Qureshi AI Ezzeddine MA Nasar A Suri MF Kirmani JF Janjua N Divani AA Is IV tissue plasminogen activator beneficial in patients with hyperdense artery sign? Neurology 2006, 66:1171-1174. 10.1212/ 01.wnl.0000208407.69544.5a 16636232
19. von Kummer R Meyding-Lamade U Forsting M Rosin L Rieke K Hacke W Sartor K Sensitivity and prognostic value of early CT in occlusion of the middle cerebral artery trunk Am J Neuroradiol 1994, 15:9-15. 8141071
20. Kim HS Lee DH Choi CG Kim SJ Suh DC Progression of middle cerebral artery susceptibility sign on T2*-weighted images: Its effect on recanalization and clinical outcome after thrombolysis Am J Roentgenol 2006, 187:W650-W657. 10.2214/AJR.05.0447 17114520
21. Fiebach JB Schellinger PD Gass A Kucinski T Siebler M Vill-ringer A Olkers P Hirsch JG Heiland S Wilde P et al. Stroke magnetic resonance imaging is accurate in hyperacute intrac-erebral hemorrhage: A multicenter study on the validity of stroke imaging Stroke 2004, 35:502-506. 10.1161/01.STR.0000114203.75678.88 14739410
22. Kidwell CS Chalela JA Saver JL Starkman S Hill MD Demchuk AM Butman JA Patronas N Alger JR Latour LL et al. Comparison of MRI and CT for detection of acute intracerebral hemorrhage JAMA 2004, 292:1823-1830. 10.1001/jama.292.15.1823 15494579
23. Noguchi K Ogawa T Inugami A Toyoshima H Sugawara S Hatazawa J Fujita H Shimosegawa E Kanno I Okudera T et al. Acute subarachnoid hemorrhage: MR imaging with fluid-attenuated inversion recovery pulse sequences Radiology 1995, 196:773-777. 7644642
24. Ezzeddine MA Lev MH McDonald CT Rordorf G Oliveira-Filho J Aksoy FG Farkas J Segal AZ Schwamm LH Gonzalez RG et al. CT angiography with whole brain perfused blood volume imaging: Added clinical value in the assessment of acute stroke Stroke 2002, 33:959-966. 10.1161/hs0402.105388 11935044
25. Wunderlich MT Stolz E Seidel G Postert T Gahn G Sliwka U Goertler M Conservative medical treatment and intravenous thrombolysis in acute stroke from carotid T occlusion Cerebrovasc Dis 2005, 20:355-361. 10.1159/000088063 16141716
26. Jansen O von Kummer R Forsting M Hacke W Sartor K Thrombolytic therapy in acute occlusion of the intracranial internal carotid artery bifurcation Am J Neuroradiol 1995, 16:1977-1986. 8585483
27. Graves MJ Magnetic resonance angiography Br J Radiol 1997, 70:6-28. 9059290
28. Schramm P Schellinger PD Klotz E Kallenberg K Fiebach JB Kulkens S Heiland S Knauth M Sartor K Comparison of perfusion computed tomography and computed tomography angiography source images with perfusion-weighted imaging and diffusion-weighted imaging in patients with acute stroke of less than 6 hours' duration Stroke 2004, 35:1652-1658. 10.1161/01.STR.0000131271.54098.22 15155964
29. Hunter GJ Hamberg LM Ponzo JA Huang-Hellinger FR Morris PP Rabinov J Farkas J Lev MH Schaefer PW Ogilvy CS et al. Assessment of cerebral perfusion and arterial anatomy in hyperacute stroke with three-dimensional functional CT: Early clinical results Am J Neuroradiol 1998, 19:29-37. 9432154
30. Fiebach JB Schellinger PD Jansen O Meyer M Wilde P Bender J Schramm P Juttler E Oehler J Hartmann M et al. CT and diffusion-weighted MR imaging in randomized order: Diffusion-weighted imaging results in higher accuracy and lower interrater variability in the diagnosis of hyperacute ischemic stroke Stroke 2002, 33:2206-2210. 10.1161/01.STR.0000026864.20339.CB 12215588
31. Lovblad KO Laubach HJ Baird AE Curtin F Schlaug G Edelman RR Warach S Clinical experience with diffusion-weighted MR in patients with acute stroke Am J Neuroradiol 1998, 19:1061-1066. 9672012
32. Hjort N Christensen S Solling C Ashkanian M Wu O Rohl L Gyldensted C Andersen G Ostergaard L Ischemic injury detected by diffusion imaging 11 minutes after stroke Ann Neurol 2005, 58:462-465. 10.1002/ana.20595 16130095
33. Busza AL Allen KL King MD van Bruggen N Williams SR Gadian DG Diffusion-weighted imaging studies of cerebral ischemia in gerbils. Potential relevance to energy failure Stroke 1992, 23:1602-1612. 1440708
34. Nicoli F Lefur Y Denis B Ranjeva JP Confort-Gouny S Cozzone PJ Metabolic counterpart of decreased apparent diffusion coefficient during hyperacute ischemic stroke: A brain proton magnetic resonance spectroscopic imaging study Stroke 2003, 34:e82-e87. 10.1161/ 01.STR.0000078659.43423.0A 12817104
35. Schlaug G Benfield A Baird AE Siewert B Lovblad KO Parker RA Edelman RR Warach S The ischemic penumbra: Operationally defined by diffusion and perfusion MRI Neurology 1999, 53:1528-1537. 10534263
36. Marchal G Serrati C Rioux P Petit-Taboue MC Viader F de la Sayette V Le Doze F Lochon P Derlon JM Orgogozo JM et al. PET imaging of cerebral perfusion and oxygen consumption in acute ischaemic stroke: Relation to outcome Lancet 1993, 341:925-927. 10.1016/0140-6736(93)91214-7 8096267
37. Muir KW Buchan A von Kummer R Rother J Baron JC Imaging of acute stroke Lancet Neurol 2006, 5:755-768. 10.1016/S1474-4422(06)70545-2 16914404
38. Wintermark M Meuli R Browaeys P Reichhart M Bogousslavsky J Schnyder P Michel P Comparison of CT perfusion and angiography and MRI in selecting stroke patients for acute treatment Neurology 2007, 68:694-697. 10.1212/ 01.wnl.0000255959.30107.08 17325279
39. U-King-Im JM Trivedi RA Graves MJ Harkness K Eales H Joubert I Koo B Antoun N Warburton EA Gillard JH et al. Utility of an ultrafast magnetic resonance imaging protocol in recent and semi-recent strokes J Neurol Neurosurg Psychiatry 2005, 76:1002-1005. 10.1136/jnnp.2004.046201 15965212
40. Wintermark M Sesay M Barbier E Borbely K Dillon WP East-wood JD Glenn TC Grandin CB Pedraza S Soustiel JF et al. Comparative overview of brain perfusion imaging techniques Stroke 2005, 36:e83-e99. 10.1161/ 01.STR.0000177884.72657.8b 16100027
41. Muir KW Halbert HM Baird TA McCormick M Teasdale E Visual evaluation of perfusion computed tomography in acute stroke accurately estimates infarct volume and tissue viability J Neurol Neurosurg Psychiatry 2006, 77:334-339. 10.1136/jnnp.2005.074179 16239323
42. Wintermark M Fischbein NJ Smith WS Ko NU Quist M Dillon WP Accuracy of dynamic perfusion CT with deconvolution in detecting acute hemispheric stroke Am J Neuroradiol 2005, 26:104-112. 15661711
43. Maruya J Yamamoto K Ozawa T Nakajima T Sorimachi T Kawasaki T Tanaka R Simultaneous multi-section perfusion CT and CT angiography for the assessment of acute ischemic stroke Acta Neurochir (Wien) 2005, 147:383-391. 10.1007/s00701-004-0465-3 15662567
44. Wintermark M Flanders AE Velthuis B Meuli R van Leeuwen M Goldsher D Pineda C Serena J van der Schaaf I Waaijer A et al. Perfusion-CT assessment of infarct core and penumbra: Receiver operating characteristic curve analysis in 130 patients suspected of acute hemispheric stroke Stroke 2006, 37:979-985. 10.1161/01.STR.0000209238.61459.39 16514093
45. Wintermark M Reichhart M Thiran JP Maeder P Chalaron M Schnyder P Bogousslavsky J Meuli R Prognostic accuracy of cerebral blood flow measurement by perfusion computed tomography, at the time of emergency room admission, in acute stroke patients Ann Neurol 2002, 51:417-432. 10.1002/ana.10136 11921048
46. Eastwood JD Lev MH Wintermark M Fitzek C Barboriak DP Delong DM Lee TY Azhari T Herzau M Chilukuri VR et al. Correlation of early dynamic CT perfusion imaging with whole-brain MR diffusion and perfusion imaging in acute hemispheric stroke Am J Neuroradiol 2003, 24:1869-1875. 14561618
47. Hellier KD Hampton JL Guadagno JV Higgins NP Antoun N Day DJ Gillard JH Warburton EA Baron JC Perfusion CT helps decision making for thrombolysis when there is no clear time of onset J Neurol Neurosurg Psychiatry 2006, 77:417-419. 10.1136/jnnp.2005.067363 16484659
48. Petersen ET Zimine I Ho YC Golay X Non-invasive measurement of perfusion: A critical review of arterial spin labelling techniques Br J Radiol 2006, 79:688-701. 10.1259/bjr/67705974 16861326
49. Sobesky J Zaro Weber O Lehnhardt FG Hesselmann V Thiel A Dohmen C Jacobs A Neveling M Heiss WD Which time-to-peak threshold best identifies penumbral flow? A comparison of perfusion-weighted magnetic resonance imaging and positron emission tomography in acute ischemic stroke Stroke 2004, 35:2843-2847. 10.1161/01.STR.0000147043.29399.f6 15514190
50. Grandin CB Duprez TP Smith AM Oppenheim C Peeters A Robert AR Cosnard G Which MR-derived perfusion parameters are the best predictors of infarct growth in hyperacute stroke? Comparative study between relative and quantitative measurements Radiology 2002, 223:361-370. 10.1148/ radiol.2232010673 11997538
51. Barber PA Davis SM Darby DG Desmond PM Gerraty RP Yang Q Jolley D Donnan GA Tress BM Absent middle cerebral artery flow predicts the presence and evolution of the ischemic penumbra Neurology 1999, 52:1125-1132. 10214732
52. Staroselskaya IA Chaves C Silver B Linfante I Edelman RR Caplan L Warach S Baird AE Relationship between magnetic resonance arterial patency and perfusion-diffusion mismatch in acute ischemic stroke and its potential clinical use Arch Neurol 2001, 58:1069-1074. 10.1001/archneur.58.7.1069 11448295
53. Singer OC Du Mesnil De Rochemont R Foerch C Stengel A Sitzer M Lanfermann H Neumann-Haefelin T Early functional recovery and the fate of the diffusion/perfusion mismatch in patients with proximal middle cerebral artery occlusion Cerebrovasc Dis 2004, 17:13-20. 10.1159/ 000073893 14530633
54. Baird AE Lovblad KO Dashe JF Connor A Burzynski C Schlaug G Straroselskaya I Edelman RR Warach S Clinical correlations of diffusion and perfusion lesion volumes in acute ischemic stroke Cerebrovasc Dis 2000, 10:441-448. 10.1159/000016105 11070374
55. Jansen O Schellinger P Fiebach J Hacke W Sartor K Early recanalisation in acute ischaemic stroke saves tissue at risk defined by MRI Lancet 1999, 353:2036-2037. 10.1016/S0140-6736(99)01146-0 10376621
56. Hjort N Butcher K Davis SM Kidwell CS Koroshetz WJ Rother J Schellinger PD Warach S Ostergaard L Magnetic resonance imaging criteria for thrombolysis in acute cerebral infarct Stroke 2005, 36:388-397. 10.1161/ 01.STR.0000152268.47919.be 15618445
57. Baird TA Parsons MW Phanh T Butcher KS Desmond PM Tress BM Colman PG Chambers BR Davis SM Persistent poststroke hyperglycemia is independently associated with infarct expansion and worse clinical outcome Stroke 2003, 34:2208-2214. 10.1161/01.STR.0000085087.41330.FF 12893952
58. Allport LE Parsons MW Butcher KS MacGregor L Desmond PM Tress BM Davis SM Elevated hematocrit is associated with reduced reperfusion and tissue survival in acute stroke Neurology 2005, 65:1382-1387. 10.1212/ 01.wnl.0000183057.96792.a8 16275824
59. Ay H Koroshetz WJ Vangel M Benner T Melinosky C Zhu M Menezes N Lopez CJ Sorensen AG Conversion of ischemic brain tissue into infarction increases with age Stroke 2005, 36:2632-2636. 10.1161/ 01.STR.0000189991.23918.01 16269639
60. Singhal AB Benner T Roccatagliata L Koroshetz WJ Schaefer PW Lo EH Buonanno FS Gonzalez RG Sorensen AG A pilot study of normobaric oxygen therapy in acute ischemic stroke Stroke 2005, 36:797-802. 10.1161/ 01.STR.0000158914.66827.2e 15761201
61. Thomalla GJ Kucinski T Schoder V Fiehler J Knab R Zeumer H Weiller C Rother J Prediction of malignant middle cerebral artery infarction by early perfusion - and diffusion-weighted magnetic resonance imaging Stroke 2003, 34:1892-1899. 10.1161/01.STR.0000081985.44625.B6 12855829
62. Oppenheim C Samson Y Manai R Lalam T Vandamme X Crozier S Srour A Cornu P Dormont D Rancurel G Prediction of malignant middle cerebral artery infarction by diffusion-weighted imaging Stroke 2000, 31:2175-2181. 10978048
63. Kidwell CS Saver JL Mattiello J Starkman S Vinuela F Duckwiler G Gobin YP Jahan R Vespa P Villablanca JP Diffusion-perfusion MRI characterization of post-recanalization hyperperfusion in humans Neurology 2001, 57:2015-2021. 11739819
64. Rother J de Crespigny AJ D'Arceuil H Iwai K Moseley ME Recovery of apparent diffusion coefficient after ischemia-induced spreading depression relates to cerebral perfusion gradient Stroke 1996, 27:980-986. discussion 986-987 8623122
65. Kidwell CS Saver JL Mattiello J Starkman S Vinuela F Duckwiler G Gobin YP Jahan R Vespa P Kalafut M Thrombolytic reversal of acute human cerebral ischemic injury shown by diffusion/perfusion magnetic resonance imaging Ann Neurol 2000, 47:462-469. 10.1002/ 1531-8249(200004)47:4<462::AID-ANA9>3.0.CO;2-Y 10762157
66. Fiehler J Knudsen K Kucinski T Kidwell CS Alger JR Thomalla G Eckert B Wittkugel O Weiller C Zeumer H Predictors of apparent diffusion coefficient normalization in stroke patients Stroke 2004, 35:514-519. 10.1161/01.STR.0000114873.28023.C2 14739409
67. Guadagno JV Warburton EA Aigbirhio FI Smielewski P Fryer TD Harding S Price CJ Gillard JH Carpenter TA Baron JC Does the acute diffusion-weighted imaging lesion represent penumbra as well as core? A combined quantitative PET/MRI voxel-based study J Cereb Blood Flow Metab 2004, 24:1249-1254. 10.1097/01.WCB.0000141557.32867.6B 15545920
68. Guadagno JV Warburton EA Jones PS Day DJ Aigbirhio FI Fryer TD Harding S Price CJ Green HA Barret O How affected is oxygen metabolism in DWI lesions?: A combined acute stroke PET-MR study Neurology 2006, 67:824-829. 10.1212/01.wnl.0000233984.66907.db 16966545
69. Rose SE Janke AL Griffin M Finnigan S Chalk JB Improved prediction of final infarct volume using bolus delay-corrected perfusion-weighted MRI: implications for the ischemic penumbra Stroke 2004, 35:2466-2471. 10.1161/01.STR.0000145199.64907.5a 15472086
70. Sobesky J Zaro Weber O Lehnhardt FG Hesselmann V Neveling M Jacobs A Heiss WD Does the mismatch match the penumbra? Magnetic resonance imaging and positron emission tomography in early ischemic stroke Stroke 2005, 36:980-985. 10.1161/01.STR.0000160751.79241.a3 15790950
71. Khaja AM Grotta JC Established treatments for acute ischaemic stroke Lancet 2007, 369:319-330. 10.1016/S0140-6736(07)60154-8 17258672
72. Adams HP Jr del Zoppo G Alberts MJ Bhatt DL Brass L Furlan A Grubb RL Higashida RT Jauch EC Kidwell C et al. Guidelines for the early management of adults with ischemic stroke: A guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists Stroke 2007, 38:1655-1711. 10.1161/ STROKEAHA.107.181486 17431204
73. Demchuk AM Hill MD Barber PA Silver B Patel SC Levine SR Importance of early ischemic computed tomography changes using ASPECTS in NINDS rtPA Stroke Study Stroke 2005, 36:2110-2115. 10.1161/ 01.STR.0000181116.15426.58 16166579
74. Fiehler J Remmele C Kucinski T Rosenkranz M Thomalla G Weiller C Zeumer H Rother J Reperfusion after severe local perfusion deficit precedes hemorrhagic transformation: An MRI study in acute stroke patients Cerebrovasc Dis 2005, 19:117-124. 10.1159/000083180 15640606
75. Alsop DC Makovetskaya E Kumar S Selim M Schlaug G Markedly reduced apparent blood volume on bolus contrast magnetic resonance imaging as a predictor of hemorrhage after thrombolytic therapy for acute ischemic stroke Stroke 2005, 36:746-750. 10.1161/01.STR.0000158913.91058.93 15746457
76. Warach S Latour LL Evidence of reperfusion injury, exacerbated by thrombolytic therapy, in human focal brain ischemia using a novel imaging marker of early blood-brain barrier disruption Stroke 2004, 35(11 Suppl 1):2659-2661. 10.1161/01.STR.0000144051.32131.09 15472105
77. Thomalla G Sobesky J Kohrmann M Fiebach JB Fiehler J Zaro Weber O Kruetzelmann A Kucinski T Rosenkranz M Rother J et al. Two tales: Hemorrhagic transformation but not parenchymal hemorrhage after thrombolysis is related to severity and duration of ischemia: MRI study of acute stroke patients treated with intravenous tissue plasminogen activator within 6 hours Stroke 2007, 38:313-318. 10.1161/01.STR.0000254565.51807.22 17204683
78. Kakuda W Thijs VN Lansberg MG Bammer R Wechsler L Kemp S Moseley ME Marks MP Albers GW Clinical importance of microbleeds in patients receiving IV thrombolysis Neurology 2005, 65:1175-1178. 10.1212/ 01.wnl.0000180519.27680.0f 16247042
79. Kidwell CS Saver JL Villablanca JP Duckwiler G Fredieu A Gough K Leary MC Starkman S Gobin YP Jahan R Magnetic resonance imaging detection of microbleeds before thrombolysis: An emerging application Stroke 2002, 33:95-98. 10.1161/hs0102.101792 11779895
80. Chalela JA Kidwell CS Nentwich LM Luby M Butman JA Demchuk AM Hill MD Patronas N Latour L Warach S Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: A prospective comparison Lancet 2007, 369:293-298. 1859855 17258669 10.1016/S0140-6736(07)60151-2
81. Kang DW Chalela JA Dunn W Warach S MRI screening before standard tissue plasminogen activator therapy is feasible and safe Stroke 2005, 36:1939-1943. 10.1161/01.STR.0000177539.72071.f0 16081864
82. Schellinger PD Jansen O Fiebach JB Pohlers O Ryssel H Heiland S Steiner T Hacke W Sartor K Feasibility and practicality of MR imaging of stroke in the management of hyperacute cerebral ischemia Am J Neuroradiol 2000, 21:1184-1189. 10954266
83. Reeves MJ Arora S Broderick JP Frankel M Heinrich JP Hicken-bottom S Karp H LaBresh KA Malarcher A Mensah G Acute stroke care in the US: results from 4 pilot prototypes of the Paul Coverdell National Acute Stroke Registry Stroke 2005, 36:1232-1240. 10.1161/ 01.STR.0000165902.18021.5b 15890989
84. Hacke W Donnan G Fieschi C Kaste M von Kummer R Broderick JP Brott T Frankel M Grotta JC Haley EC Jr et al. Association of outcome with early stroke treatment: Pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials Lancet 2004, 363:768-774. 10.1016/S0140-6736(04)15692-4 15016487
85. Albers GW Thijs VN Wechsler L Kemp S Schlaug G Skalabrin E Bammer R Kakuda W Lansberg MG Shuaib A et al. Magnetic resonance imaging profiles predict clinical response to early reperfusion: The diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) study Ann Neurol 2006, 60:508-517. 10.1002/ana.20976 17066483
86. Butcher KS Parsons M MacGregor L Barber PA Chalk J Bladin C Levi C Kimber T Schultz D Fink J et al. Refining the perfusion-diffusion mismatch hypothesis Stroke 2005, 36:1153-1159. 15914768
87. Rother J Schellinger PD Gass A Siebler M Villringer A Fiebach JB Fiehler J Jansen O Kucinski T Schoder V et al. Effect of intravenous thrombolysis on MRI parameters and functional outcome in acute stroke <6 hours Stroke 2002, 33:2438-2445. 10.1161/01.STR.0000030109.12281.23 12364735
88. Ribo M Molina CA Rovira A Quintana M Delgado P Montaner J Grive E Arenillas JF Alvarez-Sabin J Safety and efficacy of intravenous tissue plasminogen activator stroke treatment in the 3- to 6-hour window using multimodal transcranial Doppler/MRI selection protocol Stroke 2005, 36:602-606. 10.1161/01.STR.0000155737.43566.ad 15692107
89. Kohrmann M Juttler E Fiebach JB Huttner HB Siebert S Schwark C Ringleb PA Schellinger PD Hacke W MRI versus CT-based thrombolysis treatment within and beyond the 3 h time window after stroke onset: A cohort study Lancet Neurol 2006, 5:661-667. 10.1016/S1474-4422(06)70499-9 16857571
90. Thomalla G Schwark C Sobesky J Bluhmki E Fiebach JB Fiehler J Zaro Weber O Kucinski T Juettler E Ringleb PA et al. Outcome and symptomatic bleeding complications of intravenous thrombolysis within 6 hours in MRI-selected stroke patients: Comparison of a German multicenter study with the pooled data of ATLANTIS, ECASS, and NINDS tPA trials Stroke 2006, 37:852-858. 10.1161/01.STR.0000204120.79399.72 16439696
91. Schellinger P Thomalla G Kohrmann M MRI-based thrombolysis is at least as safe and effective as standard CT-based treatment: A multicenter study of 1210 patients [abstract] Stroke 2007, 38:454.
92. Hacke W Albers G Al-Rawi Y Bogousslavsky J Davalos A Eliasziw M Fischer M Furlan A Kaste M Lees KR et al. The Desmoteplase in Acute Ischemic Stroke Trial (DIAS): A phase II MRI-based 9-hour window acute stroke thrombolysis trial with intravenous desmoteplase Stroke 2005, 36:66-73. 10.1161/01.STR.0000149938.08731.2c 15569863
93. Furlan AJ Eyding D Albers GW Al-Rawi Y Lees KR Rowley HA Sachara C Soehngen M Warach S Hacke W Dose Escalation of Desmoteplase for Acute Ischemic Stroke (DEDAS): Evidence of safety and efficacy 3 to 9 hours after stroke onset Stroke 2006, 37:1227-1231. 10.1161/ 01.STR.0000217403.66996.6d 16574922
94. Ostrem JL Saver JL Alger JR Starkman S Leary MC Duckwiler G Jahan R Vespa P Villablanca JP Gobin YP et al. Acute basilar artery occlusion: diffusion-perfusion MRI characterization of tissue salvage in patients receiving intra-arterial stroke therapies Stroke 2004, 35:e30-e34. 10.1161/01.STR.0000113783.45745.BE 14739412
95. Warach S Pettigrew LC Dashe JF Pullicino P Lefkowitz DM Sabounjian L Harnett K Schwiderski U Gammans R Effect of citicoline on ischemic lesions as measured by diffusion-weighted magnetic resonance imaging. Citicoline 010 Investigators Ann Neurol 2000, 48:713-722. 10.1002/ 1531-8249(200011)48:5<713::AID-ANA4>3.0.CO;2-# 11079534
96. Nakajima S Meyer JS Amano T Shaw T Okabe T Mortel KF Cerebral vasomotor responsiveness during 100% oxygen inhalation in cerebral ischemia Arch Neurol 1983, 40:271-276. 6847419
97. Vahedi K Hofmeijer J Juettler E Vicaut E George B Algra A Amelink GJ Schmiedeck P Schwab S Rothwell PM et al. Early decompressive surgery in malignant infarction of the middle cerebral artery: A pooled analysis of three randomised controlled trials Lancet Neurol 2007, 6:215-222. 10.1016/S1474-4422(07)70036-4 17303527
98. Jaramillo A Gongora-Rivera F Labreuche J Hauw JJ Amarenco P Predictors for malignant middle cerebral artery infarctions: A postmortem analysis Neurology 2006, 66:815-820. 10.1212/01.wnl.0000203649.60211.0e 16567697
99. Serena J Blanco M Castellanos M Silva Y Vivancos J Moro MA Leira R Lizasoain I Castillo J Davalos A The prediction of malignant cerebral infarction by molecular brain barrier disruption markers Stroke 2005, 36:1921-1926. 10.1161/01.STR.0000177870.14967.94 16100032
100. Schwab S Georgiadis D Berrouschot J Schellinger PD Graffagnino C Mayer SA Feasibility and safety of moderate hypothermia after massive hemispheric infarction Stroke 2001, 32:2033-2035. 11546893
101. Krieger DW De Georgia MA Abou-Chebl A Andrefsky JC Sila CA Katzan IL Mayberg MR Furlan AJ Cooling for acute ischemic brain damage (cool aid): an open pilot study of induced hypothermia in acute ischemic stroke Stroke 2001, 32:1847-1854. 11486115
102. De Georgia MA Krieger DW Abou-Chebl A Devlin TG Jauss M Davis SM Koroshetz WJ Rordorf G Warach S Cooling for Acute Ischemic Brain Damage (COOL AID): A feasibility trial of endovascular cooling Neurology 2004, 63:312-317. 15277626
103. Berger C Schramm P Schwab S Reduction of diffusion-weighted MRI lesion volume after early moderate hypothermia in ischemic stroke Stroke 2005, 36:e56-e58. 10.1161/01.STR.0000151328.70519.e9 15914760
104. Ahmed N Nasman P Wahlgren NG Effect of intravenous nimodipine on blood pressure and outcome after acute stroke Stroke 2000, 31:1250-1255. 10835440
105. Geisler BS Brandhoff F Fiehler J Saager C Speck O Rother J Zeumer H Kucinski T Blood-oxygen-level-dependent MRI allows metabolic description of tissue at risk in acute stroke patients Stroke 2006, 37:1778-1784. 10.1161/01.STR.0000226738.97426.6f 16741186
106. Sun PZ Zhou J Sun W Huang J van Zijl PC Detection of the ischemic penumbra using pH-weighted MRI J Cereb Blood Flow Metab 2007, 27:1129-1136. 10.1038/sj.jcbfm.9600424 17133226
107. Baron JC How healthy is the acutely reperfused ischemic penumbra? Cerebrovasc Dis 2005, 20(Suppl 2):25-31. 10.1159/000089354 16327251
108. Saur D Buchert R Knab R Weiller C Rother J Iomazenil-single-photon emission computed tomography reveals selective neuronal loss in magnetic resonance-defined mismatch areas Stroke 2006, 37:2713-2719. 10.1161/ 01.STR.0000244827.36393.8f 17023671