医学
溶栓
流体衰减反转恢复
缺血性中风
冲程(发动机)
急性中风
心脏病学
大脑中动脉
梗塞
灌注扫描
内科学
灌注
磁共振成像
放射科
组织纤溶酶原激活剂
缺血
心肌梗塞
工程类
机械工程
作者
Xuya Huang,Vafa Alakbarzade,Nader Khandanpour,Anthony Pereira
出处
期刊:Practical Neurology
[BMJ]
日期:2019-03-14
卷期号:19 (4): 326-331
被引量:5
标识
DOI:10.1136/practneurol-2018-002179
摘要
Current national guidelines advocate intravenous thrombolysis to treat patients with acute ischaemic stroke presenting within 4.5 hours from symptom onset, and thrombectomy for patients with anterior circulation ischaemic stroke from large vessel occlusion presenting within 6 hours from onset. However, a substantial group of patients presents with acute ischaemic stroke beyond these time windows or has an unknown time of onset. Recent studies are set to revolutionise treatment for these patients. Using MRI diffusion/FLAIR (fluid-attenuated inversion recovery) mismatch, it is possible to identify patients within 4.5 hours from onset and safely deliver thrombolysis. Using CT perfusion imaging, it is possible to identify subjects with a middle cerebral artery syndrome who have an extensive area of ischaemic brain but as yet have only a small area of infarction who may benefit from urgent thrombectomy in up to 24 hours. Here, we highlight the recent advances in late window stroke treatment and their potential contribution to clinical practice.
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