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Clinical and Translational Neuroscience is published by MDPI from Volume 5 Issue 2 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with SAGE.
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Technical Note

Still Restricted Usability of Imaging Criteria in Therapeutic Decisions for Acute Ischemic Stroke Treatment

by
Simon Jung
1,*,
Thomas Horvath
1,
Sarah Zimmel
1,
Pascal J Mosimann
2,
Hakim Arsany
2,
Marcel Arnold
1 and
Claudio Bassetti
1
1
Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland
2
University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
*
Author to whom correspondence should be addressed.
Clin. Transl. Neurosci. 2018, 2(1), 7; https://doi.org/10.1177/2514183x18759132
Submission received: 17 July 2017 / Accepted: 22 January 2018 / Published: 14 March 2018

Abstract

A 90-year-old woman developed a severe stroke (National Institutes of Health Stroke Scale Score (NIHSS) 24) due to an occlusion of the left carotid T. Computed tomography 60 min after symptom onset showed a large area of tissue at risk with a relatively large area of reduced cerebral blood volume indicating a relative large infarct core. After successful reperfusion, she recovered very well with only residual facial asymmetry (NIHSS 1). Up to now, therapeutic decisions for intravenous thrombolysis and endovascular treatment were mainly based on these time windows, although it was well known that the individual time window may vary widely due to a large variability of the quality of collateral circulation. The recently presented results of the DAWN trial have demonstrated that patients can be successfully treated in a time window up to 24 h when selected by imaging and clinical criteria. The described case impressively demonstrates that this positive selection of patients beyond established treatment time windows does not implicate in reverse that patient selection for therapy within the established time windows can be based on the same imaging criteria. In conclusion, patient selection beyond the established time windows may be based on the available techniques, but imaging-based decisions against therapy in patients within the established time windows should be made only with extreme caution.
Keywords: stroke; imaging; penumbra; therapy; recanalization stroke; imaging; penumbra; therapy; recanalization

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MDPI and ACS Style

Jung, S.; Horvath, T.; Zimmel, S.; Mosimann, P.J.; Arsany, H.; Arnold, M.; Bassetti, C. Still Restricted Usability of Imaging Criteria in Therapeutic Decisions for Acute Ischemic Stroke Treatment. Clin. Transl. Neurosci. 2018, 2, 7. https://doi.org/10.1177/2514183x18759132

AMA Style

Jung S, Horvath T, Zimmel S, Mosimann PJ, Arsany H, Arnold M, Bassetti C. Still Restricted Usability of Imaging Criteria in Therapeutic Decisions for Acute Ischemic Stroke Treatment. Clinical and Translational Neuroscience. 2018; 2(1):7. https://doi.org/10.1177/2514183x18759132

Chicago/Turabian Style

Jung, Simon, Thomas Horvath, Sarah Zimmel, Pascal J Mosimann, Hakim Arsany, Marcel Arnold, and Claudio Bassetti. 2018. "Still Restricted Usability of Imaging Criteria in Therapeutic Decisions for Acute Ischemic Stroke Treatment" Clinical and Translational Neuroscience 2, no. 1: 7. https://doi.org/10.1177/2514183x18759132

APA Style

Jung, S., Horvath, T., Zimmel, S., Mosimann, P. J., Arsany, H., Arnold, M., & Bassetti, C. (2018). Still Restricted Usability of Imaging Criteria in Therapeutic Decisions for Acute Ischemic Stroke Treatment. Clinical and Translational Neuroscience, 2(1), 7. https://doi.org/10.1177/2514183x18759132

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