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Cerebral perfusion imaging in hemodynamic stroke: be aware of the pattern.

Siemund, Roger LU ; Cronqvist, Mats LU ; Andsberg, Gunnar LU ; Ramgren, Birgitta LU ; Knutsson, Linda LU and Holtås, Stig LU (2009) In Interventional Neuroradiology 15(4). p.385-394
Abstract
Summary: Reduction of the cerebral perfusion pressure caused by vessel occlusion or stenosis is a cause of neurological symptoms and border-zone infarctions. The aim of this article is to describe perfusion patterns in hemodynamic stroke, to give a practical approach for the assessment of colour encoded CT- and MR-perfusion maps and to demonstrate the clinical use of comprehensive imaging in the workup of patients with hemodynamic stroke. Five patients with different duration cause and degree of hemodynamic stroke were selected. The patients shared the typical presentation with fluctuating and transient symptoms. All were examined by MR or CT angiography and MR or CT perfusion in the symptomatic phase. All patients were examined with... (More)
Summary: Reduction of the cerebral perfusion pressure caused by vessel occlusion or stenosis is a cause of neurological symptoms and border-zone infarctions. The aim of this article is to describe perfusion patterns in hemodynamic stroke, to give a practical approach for the assessment of colour encoded CT- and MR-perfusion maps and to demonstrate the clinical use of comprehensive imaging in the workup of patients with hemodynamic stroke. Five patients with different duration cause and degree of hemodynamic stroke were selected. The patients shared the typical presentation with fluctuating and transient symptoms. All were examined by MR or CT angiography and MR or CT perfusion in the symptomatic phase. All patients were examined with diffusion weighted imaging. All five cases showed the altered perfusion patterns of hemodynamic insufficiency with a slight or marked increase in CBV in the supply area of the affected vessel and only slightly reduced or maintained CBF. The perfusion disturbances were most easily detected on the MTT maps. Border-zone infarctions were seen in all cases. The typical pattern for hemodynamic insufficiency is characterized by increased CBV, normal or decreased CBF and prolonged MTT in the affected areas. The increased CBV is the hallmark of stressed autoregulation. Reading the color-encoded perfusion maps enables a quick and robust assessment of the cerebral perfusion and its characteristic patterns. Internal border-zone infarctions can be regarded as a marker for hemodynamic insufficiency. Finding of the typical rosary-like pattern of DWI lesions should call for further work up. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Interventional Neuroradiology
volume
15
issue
4
pages
385 - 394
publisher
Centauro srl
external identifiers
  • WOS:000281008400002
  • PMID:20465874
  • Scopus:76549104025
ISSN
1591-0199
language
English
LU publication?
yes
id
39d12374-26c7-405f-b019-da443d1603ba (old id 1610285)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20465874?dopt=Abstract
date added to LUP
2010-06-02 10:30:10
date last changed
2016-10-13 04:35:04
@misc{39d12374-26c7-405f-b019-da443d1603ba,
  abstract     = {Summary: Reduction of the cerebral perfusion pressure caused by vessel occlusion or stenosis is a cause of neurological symptoms and border-zone infarctions. The aim of this article is to describe perfusion patterns in hemodynamic stroke, to give a practical approach for the assessment of colour encoded CT- and MR-perfusion maps and to demonstrate the clinical use of comprehensive imaging in the workup of patients with hemodynamic stroke. Five patients with different duration cause and degree of hemodynamic stroke were selected. The patients shared the typical presentation with fluctuating and transient symptoms. All were examined by MR or CT angiography and MR or CT perfusion in the symptomatic phase. All patients were examined with diffusion weighted imaging. All five cases showed the altered perfusion patterns of hemodynamic insufficiency with a slight or marked increase in CBV in the supply area of the affected vessel and only slightly reduced or maintained CBF. The perfusion disturbances were most easily detected on the MTT maps. Border-zone infarctions were seen in all cases. The typical pattern for hemodynamic insufficiency is characterized by increased CBV, normal or decreased CBF and prolonged MTT in the affected areas. The increased CBV is the hallmark of stressed autoregulation. Reading the color-encoded perfusion maps enables a quick and robust assessment of the cerebral perfusion and its characteristic patterns. Internal border-zone infarctions can be regarded as a marker for hemodynamic insufficiency. Finding of the typical rosary-like pattern of DWI lesions should call for further work up.},
  author       = {Siemund, Roger and Cronqvist, Mats and Andsberg, Gunnar and Ramgren, Birgitta and Knutsson, Linda and Holtås, Stig},
  issn         = {1591-0199},
  language     = {eng},
  number       = {4},
  pages        = {385--394},
  publisher    = {ARRAY(0x91885d8)},
  series       = {Interventional Neuroradiology},
  title        = {Cerebral perfusion imaging in hemodynamic stroke: be aware of the pattern.},
  volume       = {15},
  year         = {2009},
}