Physiologic imaging in acute stroke: Patient selection

Interv Neuroradiol. 2015 Aug;21(4):499-510. doi: 10.1177/1591019915587227. Epub 2015 Jun 10.

Abstract

Treatment of acute stroke is changing, as endovascular intervention becomes an important adjunct to tissue plasminogen activator. An increasing number of sophisticated physiologic imaging techniques have unique advantages and applications in the evaluation, diagnosis, and treatment-decision making of acute ischemic stroke. In this review, we first highlight the strengths, weaknesses, and possible indications for various stroke imaging techniques. How acute imaging findings in each modality have been used to predict functional outcome is discussed. Furthermore, there is an increasing emphasis on using these state-of-the-art imaging modalities to offer maximal patient benefit through IV therapy, endovascular thrombolytics, and clot retrieval. We review the burgeoning literature in the determination of stroke treatment based on acute, physiologic imaging findings.

Keywords: Stroke; angiography; multimodal imaging; patient selection; prospective studies; thrombolytic therapy.

Publication types

  • Review

MeSH terms

  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / physiopathology
  • Humans
  • Magnetic Resonance Imaging
  • Patient Selection
  • Stroke / diagnostic imaging*
  • Stroke / physiopathology*
  • Stroke / therapy
  • Tomography, X-Ray Computed