Advanced Neuroimaging of Acute Ischemic Stroke: Penumbra and Collateral Assessment

Neuroimaging Clin N Am. 2018 Nov;28(4):585-597. doi: 10.1016/j.nic.2018.06.004. Epub 2018 Sep 15.


Acute ischemic stroke (AIS) occurs when there is a sudden loss in cerebral blood flow due to embolic or thromboembolic occlusion of a cerebral or cervical artery. Patients with AIS require emergent neuroimaging to guide treatment, which includes intravenous thrombolysis and endovascular mechanical thrombectomy (EMT). Recent advances in AIS treatment by EMT has been driven in part by advances in computed tomography (CT) and MR imaging neuroimaging evaluation of ischemic penumbra and pial collateral vessels. The authors review advanced noninvasive brain imaging by CT and MR imaging for the evaluation of AIS focusing on penumbral and collateral imaging.

Keywords: CT; Collaterals; Infarction; MR imaging; MRA; Penumbra; Perfusion; Stroke.

Publication types

  • Review

MeSH terms

  • Brain / diagnostic imaging
  • Brain Ischemia / complications
  • Brain Ischemia / diagnostic imaging*
  • Diagnostic Imaging / methods*
  • Humans
  • Neuroimaging / methods*
  • Stroke / complications
  • Stroke / diagnostic imaging*