Time is Essential to Spare Brain After Ischemic Stroke: Less than 3 Hours Window

StrokeThe Massachusetts General Hospital acute stroke imaging algorithm: an experience and evidence based approach.

The Massachusetts General Hospital Neuroradiology Division employed an experience and evidence based approach to develop a neuroimaging algorithm to best select patients with severe ischemic strokes caused by anterior circulation occlusions (ACOs) for intravenous tissue plasminogen activator and endovascular treatment.

Methods found to be of value included the National Institutes of Health Stroke Scale (NIHSS), non-contrast CT, CT angiography (CTA) and diffusion MRI. Perfusion imaging by CT and MRI were found to be unnecessary for safe and effective triage of patients with severe ACOs. An algorithm was adopted that includes: non-contrast CT to identify hemorrhage and large hypodensity followed by CTA to identify the ACO; diffusion MRI to estimate the core infarct; and NIHSS in conjunction with diffusion data to estimate the clinical penumbra.

Read full article: The Massachusetts General Hospital acute stroke imaging algorithm (PDF)

Similar Posts

Treat atrial fibrillation AF to prevent stroke

PRADAXA 150 mg twice daily provided an additional 35% risk reduction of stroke/systemic embolism vs warfarin Superior reduction of ischemic and hemorrhagic stroke vs warfarin Similar rate of major bleeds‡ with PRADAXA vs warfarin PRADAXA is the ONLY anticoagulant to demonstrate superior reduction of ischemic stroke vs warfarin PRADAXA also demonstrated a lower rate of…

New Approaches to Monitor Stroke

Stroke is a common, potentially devastating disease with potential high morbidity and mortality. Recognition at the onset of acute ischemic stroke is pivotal to changing outcomes such as intravenous thrombolysis. Stroke monitoring is a burgeoning field with various methods described and newer devices that aid in detecting acute or worsening ischemia that can lead to…

|

More Evidence Dark Chocolate Is Cardioprotective

The blood pressure–lowering and lipid effects of dark chocolate could be an effective — and money-saving — strategy for preventing cardiovascular events in high-risk patients, a new study suggests. “The findings of this study suggest that the blood pressure lowering and lipid effects of plain dark chocolate could represent an effective and cost effective strategy…

Can we reduce the risk of recurrent event after a TIA or minor stroke? New study shows benefit of Clopidogrel with Aspirine

Stroke is common during the first few weeks after a transient ischemic attack (TIA) or minor ischemic stroke. Combination therapy with clopidogrel and aspirin may provide greater protection against subsequent stroke than aspirin alone. In a randomized, double-blind, placebo-controlled trial conducted at 114 centers in China, we randomly assigned 5170 patients within 24 hours after…

New Ischemic Stroke Guidelines

Ischemic Stroke Guidelines released at the end of January 2013. These guidelines were put together by an expert panel and touch on many aspects of acute stroke care, with a focus on ischemic stroke. The guidelines include dozens of recommendations. I am not going to talk about all of them today, but I would like…