Vascular disease: Getting the measure of stroke (original) (raw)

2002, Nature Reviews Drug Discovery

When attempting to treat stroke, it pays to know the nature of the beast. Acute stroke consists of an evolving infarction-an area of brain tissue that is damaged beyond repair-surrounded by an 'ischaemic penumbra', which, although threatened, can potentially be rescued by restoring blood flow to the affected area. But brain 'reperfusion' with thrombolytic agents carries with it the risk of haemorraghic complications, and is effective only in those cases in which there is a penumbra to save. So, how to tell when to use it? A study published in the Annals of Neurology now shows how a new version of X-ray computed tomography (CT) can be used in acute stroke patients to decide whether reperfusion will be effective, and also to predict the final infarct size and expected clinical progression. Stroke diagnosis has relied on the use of CT for more than 30 years, but this study uses a modern variant, perfusion CT, that can generate brain images at a much faster rate. Perfusion CT can be used to monitor the passage of injected CT dye through the brain, and therefore to create maps of cerebral blood volume and cerebral

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