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• W1596960302 abstract "Stroke is a leading cause of death and a major cause of long term disabilities worldwide. According to the World Health Organization (WHO), a total of 15 million people suffer from a stroke each year comprising 5 million with a fatal outcome and another 5 million with permanent disabilities. While prevention research identifies factors and specific drugs that may lower the risk of a future stroke, the treatment of ischemic stroke patients aims at maximizing the recovery of brain tissue at risk. It is typically done by arterial recanalization of the vessel where the clot is located. Identification of salvageable brain tissue is essential during the clinical decision-making process. As a general rule for the decision to intervene, the expected benefits of the intervention should outweigh its potential risks and costs. To identify viable brain tissue, time is considered as a determining factor in the treatment of stroke patients. A perfect illustration of this timing issue is the thrombolytic therapy which uses specific drugs to break-up or dissolve the blood clot. As shown in a recent study (Hacke et al, 2008), thrombolysis applied with recombinant tissue plasminogen activator (rt-PA) is effective for acute ischemic stroke patients when administered intra-venously within a specific time window (3 hours, or 4 hours 30 min for patients meeting additional criteria). However, this time frame is arbitrary andmight be too restrictive for some patients (Schaefer et al., 2007). For example, some patients could have benefited from this therapy but, instead, have been unnecessarily excluded. Beyond this ongoing debate about the length of the time window, there is a recognized need for accurate strategies to quantify the extent of viable tissue for victims of ischemic strokes and therefore to be able to identify the patients who could benefit from such a therapy. Estimating the dynamic of infarct growth in ischemic stroke is extremely complex and its mechanisms are still poorly understood. Various factors such as quality of collateral perfusion, energy delivery, and age of the patient are known to have a significant impact on the outcome. However, their interactions over time is not clearly established and has not been quantified. The most commonly used techniques currently available to predict tissue outcome are based on imaging. It is widely accepted that the combination of diffusion (DWI) and perfusion-weighted (PWI) magnetic resonance imaging (MRI) provide useful information to identify the tissue at risk at an early stage. Several groups (Chen et al., 2008; Fisher & Ginsberg, 2004; Kidwell et al., 2004; Schlaug et al., 1999) have studied the mismatch between DWI and PWI to determine the penumbral tissue. However, DWI-PWI mismatch approaches have limitations: increased diffusion signals may be reversible (although a recent 13" @default.
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• W1596960302 date "2012-02-17" @default.
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• W1596960302 title "Tissue Fate Prediction from Regional Imaging Features in Acute Ischemic Stroke" @default.
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• W1596960302 doi "https://doi.org/10.5772/22890" @default.
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