Imaging the penumbra - strategies to detect tissue at risk after ischemic stroke

J Clin Neurosci. 2009 Feb;16(2):178-87. doi: 10.1016/j.jocn.2008.04.002. Epub 2008 Dec 18.


The aim of thrombolytic therapy after acute ischemic stroke is salvage of the ischemic penumbra. Several imaging techniques have been used to identify the penumbra in patients who may benefit from reperfusion beyond the currently narrow 3-hour time-window for thrombolysis. We discuss the advantages and disadvantages of positron emission tomography (PET), single photon emission computed tomography (SPECT), MRI and CT scans. We comment on concepts of clinical-imaging mismatch models and we explore the implications for clinical trials.

Publication types

  • Review

MeSH terms

  • Clinical Trials as Topic
  • Diagnostic Imaging / adverse effects*
  • Diagnostic Imaging / methods*
  • Humans
  • Reperfusion / methods
  • Risk*
  • Stroke / diagnosis*