Background And Purpose: Cerebellar infarctions constitute a significant proportion of ischemic strokes and carry a substantial morbidity and mortality mainly because of swelling in the posterior fossa. No specific acute therapy is established, and patients are usually excluded from intravenous thrombolysis (IVT).
Methods: Two patients presented in an extended time window of 5 and 7 hours to our emergency department with sudden onset of severe cerebellar symptoms. After emergency MRI demonstrated superior cerebellar artery (SCA) occlusion with hypoperfusion of the respective territory and only minor DWI lesions, IVT was administered. Both patients recovered within a few hours after therapy and follow-up MRI on day 1 after treatment demonstrated only minor infarction.
Conclusions: We present to our knowledge the first cases of MRI mismatch-based IVT in an extended time window in patients with isolated SCA-infarctions. More studies are needed to evaluate IVT in this patient population. Modern imaging techniques might be helpful to select patients for therapy in posterior circulation strokes.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1161/STROKEAHA.108.532838 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Multidelay Arterial Spin Labeling Versus Computed Tomography Perfusion in Penumbra Volume of Acute Ischemic Stroke.
Stroke
April 2023
Department of Neurology (C.Y., Y.Z., Z.W., Q.M.), Xuanwu Hospital Capital Medical University, Beijing, China.
Background: Multidelay arterial spin labeling (ASL) is a novel perfusion method of ASL, with arterial transit time (ATT) calculated by multiple postlabeling delays to correct cerebral blood flow (CBF). We verify the accuracy of multidelay ASL in evaluating the ischemic penumbra and perfusion levels in patients with acute ischemic stroke, compared with computed tomography perfusion (CTP).
Methods: Patients with acute ischemic stroke with anterior circulation large vessel occlusion received baseline CTP, multidelay ASL, and diffusion-weighted imaging (DWI) in succession.
Unknown Onset Stroke: Differences Between Patients with Wake-Up Stroke and Daytime-Unwitnessed Stroke.
J Stroke Cerebrovasc Dis
July 2021
Department of Neurology, Mannheim Center for Translational Neurosciences, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. Electronic address:
Objectives: Patients with unknown onset stroke (UOS) can be categorized as wake-up stroke (WUS) and daytime-unwitnessed stroke (DUS). We sought to determine whether decisions for initial imaging modalities, frequency of mismatch findings, resulting treatment decisions and outcome differ between WUS and DUS patients.
Materials And Methods: In a retrospective analysis, all patients with UOS admitted to our Stroke Unit from January to December 2018 were evaluated and classified as either WUS or DUS.
Objective: Accurate identification of the ischemic penumbra, the therapeutic target in acute clinical stroke, is of critical importance to identify patients who might benefit from reperfusion therapies beyond the established time windows. Therefore, we aimed to validate magnetic resonance imaging (MRI) mismatch-based penumbra detection against full quantitative positron emission tomography ( O-PET), the gold standard for penumbra detection in acute ischemic stroke.
Methods: Ten patients (group A) with acute and subacute ischemic stroke underwent perfusion-weighted (PW)/diffusion-weighted MRI and consecutive full quantitative O-PET within 48 hours of stroke onset.
Extension of therapeutic window in ischemic stroke by selective mismatch imaging.
Int J Stroke
June 2019
1 Max Planck Institute for Metabolism Research, Cologne, Germany.
The concept of the ischemic penumbra was formulated on the basis of animal experiments showing functional impairment and electrophysiologic disturbances with decreasing flow to the brain below defined values (the threshold for function) and irreversible tissue damage with blood supply further decreased (the threshold for infarction). The perfusion range between these thresholds was termed the "penumbra," and restitution of flow above the functional threshold was able to reverse the deficits without permanent damage. In further experiments, the dependency of the development of irreversible lesions on the interaction of the severity and the duration of critically reduced blood flow was established, proving that the lower the flow, the shorter the time for efficient reperfusion.
View Article and Find Full Text PDFClinical Outcomes of Endovascular Treatment within 24 Hours in Patients with Mild Ischemic Stroke and Perfusion Imaging Selection.
AJNR Am J Neuroradiol
June 2018
From the Department of Neurology (X.S., S.Z., Y.G., X.L.), Jinling Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
Background And Purpose: Endovascular thrombectomy has been accepted as the standard of care for patients with acute ischemic stroke. Our aim was to investigate the clinical outcomes of patients with mild ischemic stroke with acute proximal large-vessel occlusion after endovascular treatment within 24 hours of symptom onset.
Materials And Methods: Between January 2014 and August 2017, ninety-three Chinese patients with mild ischemic stroke (NIHSS scores, 0-8) and large-vessel occlusion with endovascular treatment were retrospectively enrolled from 7 comprehensive stroke centers.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!