State Of The Art Imaging In Stroke

Stroke represents a clinical syndrome of rapid onset of focal or sometimes global cerebral deficit with a vascular cause, lasting more than 24 hours or leading to death. Eighty per cent of all strokes are ischaemic, 15% are due to intracerebral haemorrhage, and 5% to subarachnoid haemorrhage. Correct diagnosis is important because treatment options for ischemic stroke may be contraindicated in case of intracerebral haemorrhage. Such exact diagnosis requires state-of-the-art imaging of the brain. But which kind of imaging, how quickly should it be done, should this include imaging of cerebral blood flow, and what is the most cost effective approach? Answering these questions may help to further narrow the gap between experimental and clinical research as well may substantially improve the patient's care.

One in six suffers a stroke during their lifetime and stroke remains the major cause of new onset disability in adulthood. The worldwide burden of stroke is increasing due to an ageing population, however, globally haft of stroke victims are young. Stroke is the clinical diagnosis of an acute vascular incident and covers a multitude of pathophysiological causes. The clinician needs imaging to make decisions on acute treatment as well as to plan a secondary prevention strategy: a non-contrast CT and a Duplex of the carotids followed by an aspirin as a one size fits all strategy does not always provide sufficient support for those decisions. Presently, fast, generally available, and non-invasive imaging provides new possibilities of establishing a cause of stroke, provide specific information on the brain parenchyma – including possibly salvageable tissue and micro-bleeds – as well as allowing for more specific prognostication in acute stroke. This eBook covers both ischemic and haemorrhagic stroke and includes hot topics such as micro-bleeds, salvageable tissue and spot-sign, clinically challenging issues including movement artefacts in MRI as well as an overview of present options including pragmatic and feasible suggestions for an approach to state of the art acute imaging.

This updated second edition of Acute Ischemic Stroke: Imaging and Intervention provides a comprehensive account of the state of the art in the diagnosis and treatment of acute ischemic stroke. The basic format of the first edition has been retained, with sections on fundamentals such as pathophysiology and causes, imaging techniques and interventions. However, each chapter has been revised to reflect the important recent progress in advanced neuroimaging and the use of interventional tools. In addition, a new chapter is included on the classification instruments for ischemic stroke and their use in predicting outcomes and therapeutic triage. All of the authors are internationally recognized experts and members of the interdisciplinary stroke team at the Massachusetts General Hospital and Harvard Medical School. The text is supported by numerous informative illustrations, and ease of reference is ensured through the inclusion of suitable tables. This book will serve as a unique source of up-to-date information for neurologists, emergency physicians, radiologists and other health care providers who care for the patient with acute ischemic stroke.

In recent years, a substantial number of imaging studies have addressed the neuronal processes underlying recovery after stroke. Although difficult to achieve, several longitudinal studies assessed both clinical recovery and imaging patterns over time and give important inside into the plasticity of the stroked brain. This tendency is supported by the fact that it has become possible to depict biological processes at the cellular and molecular level. Of primary interest is the development of methods using MRI and PET with which the different kinds of progress of therapy in acute ischemic stroke can be monitored and graphically displayed. The emerging studies of brain plasticity and its modulation by drugs and other therapies indicate potentially useful approaches to the rehabilitation of adults with brain damage, including damage resulting from cerebral ischaemia. State-of-the-art imaging technology is already being developed to image genes and their impact on cellular function in laboratory animals. Eventually, this may also be possible in humans. Main attention is given to imaging the post-stroke phase and its implication on treatment. This book gives important insight in the future of imaging in stroke and their interaction with clinical aspects. Stroke care has become a specialised field, requiring input from different sub-specialists forming a multidisciplinary team.

Up-to-date, detailed practical guide for neuroimaging of the acute ischemic stroke patients Experienced authors in the field of neuro imaging

One in six suffers a stroke during their lifetime and stroke remains the major cause of new onset disability in adulthood. The worldwide burden of stroke is increasing due to an ageing population, however, globally haft of stroke victims are young. Stroke is the clinical diagnosis of an acute vascular incident and covers a multitude of pathophysiological causes. The clinician needs imaging to make decisions on acute treatment as well as to plan a secondary prevention strategy: a non-contrast CT and a Duplex of the carotids followed by an aspirin as a one size fits all strategy does not always provide sufficient support for those decisions. Presently, fast, generally available, and non-invasive imaging provides new possibilities of establishing a cause of stroke, provide specific information on the brain parenchyma - including possibly salvageable tissue and micro-bleeds - as well as allowing for more specific prognostication in acute stroke. This eBook covers both ischemic and haemorrhagic stroke and includes hot topics such as micro-bleeds, salvageable tissue and spot-sign, clinically challenging issues including movement artefacts in MRI as well as an overview of present options including pragmatic and feasible suggestions for an approach to state of the art acute imaging.

Stroke MRI is a new imaging tool providing detailed information of the pathophysiological aspects of cerebral ischemia. This book - with CD-ROM - includes a case collection of 25 hyperacute stroke patients, all imaged within six hours of stroke onset with a complete stroke MRI protocol. Stroke MRI and the established clinical methods are compared and recent results from single and multicenter trials are presented to demonstrate the advantages of MRI for stroke patients. The CD-ROM contains diffusion-, T2-, T2*-perfusion-weighted images and MR angiography. The CD and the book are complementary to avoid redundancy as far as possible.

An essential companion for busy professionals seeking to navigate stroke-related clinical situations successfully and make quick informed treatment decisions.