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Information about the presence or absence of a vessel occlusion, whether by means of DU, CTA, or MRA, is essential before recombinant tissue plasminogen activator is given in the 3- to 6-hour time window. Clear demarcation of the irreversib ly damaged infarct core and the ischemic but still viable and thus salvageable tissue at risk of infarction as seen on DWI/PWI/MRA or alternatively CT/CTA/CTA-SI should be obtained before thrombolysis is initiated within 3 to 6 hours. Once these advanced techniques are used, the therapeutic time window can be extended with acceptable safety. However, comprehensive informed consent is mandatory, especially when thrombolytic therapy is considered beyond established time windows. |
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CAT scan,angiography
CAT scan,perfusion
cerebral ischemia
cerebrovascular accident
cerebrovascular accident,thrombolytic agents in treatment
controversies in neurology
fibrinolytic agents
fibrinolytic therapy,timing of administration
ischemic penumbra
middle cerebral artery,occlusion of
MRI
MRI,abnormal
MRI,angiography
MRI,mismatch between perfusion/diffusion
multimodal neuroimaging
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