1. Opportunities in multimodal neuroimaging for optimizing thrombolytic therapy for ischemic stroke
- Author
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M. M. Odinak, I. A. Voznyuk, S. N. Yanishevsky, S. Yu. Golokhvastov, N. V. Tsygan, A. Yu. Polushin, R. V. Andreev, and D. A. Mirnaya
- Subjects
ischemic stroke ,thrombolytic therapy ,multimodal neuroimaging ,perfusion-weighted magnetic resonance imaging ,diffusionweighted magnetic resonance imaging ,variants of perfusion changes ,intracranial complications due to stroke ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
The main purpose of examination of patients before thrombolytic therapy for ischemic stroke (IS) is to timely identify contraindications to the use of recombinant tissue plasminogen activator.Objective: to estimate opportunities and benefits in applying multimodal magnetic resonance imaging (MRI) to improve clinical outcomes in acute stroke, among other processes, by enhancing the efficiency and safety of thrombolytic therapy.Patients and methods. The clinical experience of the S.M. Kirov Military Medical Academy in using multimodal MRI of the brain since 2004 was analyzed in patients with stroke.Results. Comprehensive assessment of the results of perfusion-weighted MRI of the brain and those of transcranial Doppler ultrasound identified five clinically significant variants of perfusion changes in IS: normal perfusion; postischemic hyperemia; persistent hypoperfusion; acute pathological hyperperfusion, and unrecovered perfusion. With an irreversible tissue damage volume of >60 cm3 on day 1 of stroke, as evidenced by diffusion-weighted MRI, the odd ratio for cerebral edema in the acutest period of the disease is 39.4% (95% CI 2.57–2436; p
- Published
- 2016
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