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Imaging of Acute Cerebral Ischemia¹

¹ From the Morgan H. Russell Department of Radiology, Division of Neuroradiology, the Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287. Received April 16, 1998; revision requested June 24; final revision received January 13, 1999; accepted March 16. Address reprint requests to N.J.B. (e-mail: nbeauch@welchlink.welch.jhu.edu).

Abstract

Until recently, there was no efficacious treatment for acute cerebral ischemia. As a result, the role of neuroimaging and the radiologist was peripheral in the diagnosis and management of this disease. The demonstration of efficacy using thrombolysis has redefined this role, with the success of intervention becoming increasingly dependent on timely imaging and accurate interpretation. The potential benefits of intervention have only begun to be realized. In this State-of-the-Art review of imaging of acute stroke, the role of imaging in the current and future management of stroke is presented. The role of computed tomography is emphasized in that it is currently the most utilized technique, and its value has been demonstrated in prospective clinical trials. Magnetic resonance techniques are equally emphasized in that they have the potential to provide a single modality evaluation of tissue viability and vessel patency in an increasingly rapid evaluation.

Index terms: Brain, infarction, 10.781 • Brain, ischemia, 10.781 • Cerebral blood vessels, CT, 174.1211 • Cerebral blood vessels, flow dynamics, 174.76 • Cerebral blood vessels, MR, 174.12141, 174.12142, 174.12145 • State-of-art reviews

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