Which Imaging Approach Should Be Used for Stroke of Unknown Time of Onset?
Standard
Which Imaging Approach Should Be Used for Stroke of Unknown Time of Onset? / Simonsen, Claus Z; Leslie-Mazwi, Thabele M; Thomalla, Götz.
In: STROKE, Vol. 52, No. 1, 01.2021, p. 373-380.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Which Imaging Approach Should Be Used for Stroke of Unknown Time of Onset?
AU - Simonsen, Claus Z
AU - Leslie-Mazwi, Thabele M
AU - Thomalla, Götz
PY - 2021/1
Y1 - 2021/1
N2 - Reperfusion therapy with intravenous thrombolysis or mechanical thrombectomy is effective in improving outcome for ischemic stroke but remains underused. Patients presenting with stroke of unknown onset are a common clinical scenario and a common reason for not offering reperfusion therapy. Recent studies have demonstrated the efficacy of reperfusion therapy in stroke of unknown time of onset, when guided by advanced brain imaging. However, translation into clinical practice is challenged by variability in the available data. Comparison between studies is difficult because of use of different imaging modalities (magnetic resonance imaging or computed tomography), different imaging paradigms (imaging biomarkers of lesion age versus imaging biomarkers of tissue viability), and different populations studied (ie, both patients with large vessel occlusion or those with less severe strokes). Physicians involved in acute stroke care are faced with the key question of which imaging approach they should use to guide reperfusion treatment for stroke with unknown time of onset. In this review, we provide an overview of the available evidence for selecting and treating patients with strokes of unknown onset, based on the underlying imaging concepts. The perspective provided is from the viewpoint of the clinician seeing these patients acutely, to provide pragmatic recommendations for clinical practice.
AB - Reperfusion therapy with intravenous thrombolysis or mechanical thrombectomy is effective in improving outcome for ischemic stroke but remains underused. Patients presenting with stroke of unknown onset are a common clinical scenario and a common reason for not offering reperfusion therapy. Recent studies have demonstrated the efficacy of reperfusion therapy in stroke of unknown time of onset, when guided by advanced brain imaging. However, translation into clinical practice is challenged by variability in the available data. Comparison between studies is difficult because of use of different imaging modalities (magnetic resonance imaging or computed tomography), different imaging paradigms (imaging biomarkers of lesion age versus imaging biomarkers of tissue viability), and different populations studied (ie, both patients with large vessel occlusion or those with less severe strokes). Physicians involved in acute stroke care are faced with the key question of which imaging approach they should use to guide reperfusion treatment for stroke with unknown time of onset. In this review, we provide an overview of the available evidence for selecting and treating patients with strokes of unknown onset, based on the underlying imaging concepts. The perspective provided is from the viewpoint of the clinician seeing these patients acutely, to provide pragmatic recommendations for clinical practice.
KW - Biomarkers
KW - Humans
KW - Neuroimaging/methods
KW - Reperfusion
KW - Stroke/diagnostic imaging
KW - Thrombolytic Therapy
KW - Time-to-Treatment
KW - Treatment Outcome
U2 - 10.1161/STROKEAHA.120.032020
DO - 10.1161/STROKEAHA.120.032020
M3 - SCORING: Review article
C2 - 33302796
VL - 52
SP - 373
EP - 380
JO - STROKE
JF - STROKE
SN - 0039-2499
IS - 1
ER -