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Identification of penumbra in acute ischemic stroke using multimodal MR imaging analysis: A case report study

Forough Sodaei, Vahid Shahmaei

2020Radiology Case Reports18 citationsDOIOpen Access PDF

Abstract

Ischemic etiology of stroke is the most common health issue. Differentiating the ischemic core from the associated penumbra is tremendously important in tailoring an effective therapeutic strategy and potential intervention. Additionally, the degree of cell damage adjacent to the ischemic core may be either reversible or irreversible, which may also affect clinical outcomes. We describe a case of a 58-year-old female, who was diagnosed with global aphasia and fluctuating right-sided hypoesthesia. Multimodal MR imaging analysis was obtained, with cerebral blood flow and mean transit time , demonstrating an infarcted core with an even larger penumbra, suggesting potentially salvageable tissue. We concluded that quantified perfusion imaging data should be used in combination with other MR protocols to determine at-risk tissues. This case substantiates the role of multimodal imaging of the penumbra as a routine part of acute stroke workup and management.

Topics & Concepts

PenumbraMedicineStroke (engine)HypoesthesiaRadiologyNeuroimagingIschemic strokeAphasiaEtiologyAcute strokeIschemiaInternal medicineSurgeryPsychiatryEngineeringTissue plasminogen activatorMechanical engineeringAcute Ischemic Stroke ManagementTraumatic Brain Injury and Neurovascular DisturbancesCerebrovascular and Carotid Artery Diseases
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