Instrumental Diagnosis and Treatment of Acute Ischemic Stroke: The Clinician’s Perspective

It is difficult to estimate the impact of experimental work on mechanisms of induction and protection of cellular damage in the “real world” of neurological diseases. This is particularly difficult for ischemic stroke, although clinicians are now actively collaborating with basic scientists and technologists in order to implement effective therapeutic strategies for stroke victims. Important tasks for the clinician include: (1) the identification of the most appropriate diagnostic techniques, (2) the set up of organized stroke care, and (3) the design and realization of rigorous clinical trials. In the following pages, we review the current options for instrumental diagnosis and treatment of acute ischemic stroke.

[1]  H L Abrams,et al.  Complications of angiography. , 1981, Radiology.

[2]  R. Ojemann,et al.  Thresholds of focal cerebral ischemia in awake monkeys. , 1981, Journal of neurosurgery.

[3]  S. Rittgers,et al.  Audible interpretation of carotid Doppler signals. An improved technique to define carotid artery disease. , 1981, Archives of surgery.

[4]  K. Asplund,et al.  A non-intensive stroke unit reduces functional disability and the need for long-term hospitalization. , 1985, Stroke.

[5]  G. Lenzi,et al.  Comparison of cerebral angiography and transcranial Doppler sonography in acute stroke. , 1989, Stroke.

[6]  C. Pozzilli,et al.  Predictive value of brain perfusion single-photon emission computed tomography in acute ischemic stroke. , 1990, Stroke.

[7]  W A Kalender,et al.  Physical performance characteristics of spiral CT scanning. , 1991, Medical physics.

[8]  I. Holme,et al.  Benefit of a stroke unit: a randomized controlled trial. , 1991, Stroke.

[9]  C. Sotak,et al.  New magnetic resonance techniques for evaluating cerebrovascular disease , 1992, Annals of neurology.

[10]  P. Langhorne,et al.  Do stroke units save lives? , 1993, The Lancet.

[11]  D. Toni,et al.  Feasibility and usefulness of conventional spin-echo MR imaging in hyperacute ischemic stroke: a comparison with CT scan , 1993 .

[12]  G. Marchal,et al.  PET imaging of cerebral perfusion and oxygen consumption in acute ischaemic stroke: relation to outcome , 1993, The Lancet.

[13]  J. Bogousslavsky,et al.  A Glimmer of Hope for Acute Ischemic Stroke , 1994 .

[14]  M. Hennerici,et al.  Meta-Analysis of Oral Nimodipine Trials in Acute Ischemic Stroke , 1994 .

[15]  S. Sakaki,et al.  Evaluation of risk of hemorrhagic transformation in local intra-arterial thrombolysis in acute ischemic stroke by initial SPECT. , 1994, Stroke.

[16]  W. Yuh,et al.  Magnetic resonance versus computed tomographic imaging in acute stroke. , 1995, Stroke.

[17]  C. Pozzilli,et al.  Spontaneous middle cerebral artery reperfusion in ischemic stroke. A follow-up study with transcranial Doppler. , 1995, Stroke.

[18]  L. Munari,et al.  RANDOMIZED CONTROLLED TRIAL OF STREPTOKINASE, ASPIRIN, AND COMBINATION OF BOTH IN TREATMENT OF ACUTE ISCHEMIC STROKE , 1995 .

[19]  S. Otis,et al.  Contrast-enhanced transcranial imaging. Results of an American phase-two study. , 1995, Stroke.

[20]  Joseph P. Broderick,et al.  Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. , 1995 .

[21]  C. Manelfe,et al.  Early CT Diagnosis of Hemispheric Brain Infarction , 1995, Springer Berlin Heidelberg.

[22]  M. Kaste,et al.  Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS) , 1995, JAMA.

[23]  R. Edelman,et al.  Detection of hyperacute primary intraparenchymal hemorrhage by magnetic resonance imaging. , 1996, Stroke.

[24]  R R Edelman,et al.  Clinical Outcome in Ischemic Stroke Predicted by Early Diffusion-Weighted and Perfusion Magnetic Resonance Imaging: A Preliminary Analysis , 1996, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[25]  G. Donnan,et al.  Changes in cerebral tissue perfusion during the first 48 hours of ischaemic stroke: relation to clinical outcome. , 1996, Journal of neurology, neurosurgery, and psychiatry.

[26]  G. Hankey,et al.  Streptokinase for acute ischemic stroke with relationship to time of administration: Australian Streptokinase (ASK) Trial Study Group. , 1996, Journal of the American Medical Association (JAMA).

[27]  G. Hankey,et al.  Streptokinase for acute ischemic stroke with relationship to time of administration: Australian Streptokinase (ASK) Trial Study Group. , 1996, JAMA.

[28]  J. Pruvo,et al.  Helical CT for the diagnosis of extracranial internal carotid artery dissection. , 1996, Stroke.

[29]  M. Hommel,et al.  Thrombolytic therapy with streptokinase in acute ischemic stroke. , 1996, The New England journal of medicine.

[30]  J. Lewin,et al.  Good clinical outcome in a patient with a large CT scan hypodensity treated with intra-arterial urokinase after an embolic stroke , 1996, Neurology.

[31]  Fausto Viader,et al.  Spontaneous neurological recovery after stroke and the fate of the ischemic penumbra , 1996, Annals of neurology.

[32]  D. Toni,et al.  The concept of combination therapy in acute ischemic stroke , 1997, Neurology.

[33]  Langhorne,et al.  Collaborative systematic review of the randomised trials of organised inpatient (stroke unit) care after stroke , 1997, BMJ.

[34]  G. Schlaug,et al.  Enlargement of human cerebral ischemic lesion volumes measured by diffusion‐weighted magnetic resonance imaging , 1997, Annals of neurology.

[35]  S. Warach,et al.  A randomized dose-response trial of citicoline in acute ischemic stroke patients , 1997, Neurology.

[36]  A. Thiel,et al.  Ischaemic brain tissue salvaged from infarction with alteplase , 1997, The Lancet.

[37]  P. Deyn,et al.  Treatment of Acute Ischemic Stroke With Piracetam , 1997 .

[38]  J. Slattery,et al.  How do stroke units improve patient outcomes? A collaborative systematic review of the randomized trials. Stroke Unit Trialists Collaboration. , 1997, Stroke.

[39]  J. Weber,et al.  Brain and vascular imaging in acute ischemic stroke , 1997, Neurology.

[40]  W. Powers,et al.  Magnetic resonance imaging in acute stroke , 1998, Neurology.

[41]  A. Mendelow,et al.  Early computed-tomography abnormalities in acute stroke , 1997, The Lancet.

[42]  H. Diener.  Multinational Randomised Controlled Trial of Lubeluzole in Acute Ischaemic Stroke , 1998, Cerebrovascular Diseases.

[43]  P. Moore.  Human herpesvirus 8 variants , 1998, The Lancet.

[44]  M. E. Moseley,et al.  Correlation of perfusion- and diffusion-weighted MRI with NIHSS score in acute (<6.5 hour) ischemic stroke , 1998, Neurology.

[45]  J. Ferro,et al.  Neuroprotection as Initial Therapy in Acute Stroke , 1998, Cerebrovascular Diseases.

[46]  W. Hacke,et al.  Role of CT angiography in patient selection for thrombolytic therapy in acute hemispheric stroke. , 1998, Stroke.