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Role of Ultrasound Vascular Imaging in the Acute Phase of Stroke

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Abstract:

Acute ischemic stroke remains one of the main causes of death and disability in the world. The only approved therapy for stroke is the intravenous thrombolysis with recombinant tissue plasminogen activator within 3 h from symptom onset. The European, American and Canadian guidelines define unenhanced brain CT as the only imaging technique mandatory before thrombolysis. Its only goal is the exclusion of hemorrhage and not the diagnosis of ischemia, although the identification of early ischemic changes, involving more than one third of middle cerebral artery territory, was soon used in the therapeutic decision.

At the moment the need of vascular imaging in the acute phase of stroke is sustained by several researchers and the practical directions actually in progress are the diagnosis of presence and site of vessel occlusion, whose prognostic role is demonstrated, and the perfusional evaluation for the quantification of core/penumbra mismatch and the overcoming of the time window concept. The ideal tool for identify reliably, easily, reproducibly and cheaply the vascular pattern in each patient is the ultrasound technique, particularly Transcranial Colour-Coded Duplex Sonography. It allows also the real-time monitoring of recanalization process, i.e. the timing of vessel patency restoration.



Keywords: Transcranial; acute stroke; perfusion; thrombolysis; transcranial colour-coded sonography; vascular imaging

Document Type: Research Article

DOI: http://dx.doi.org/10.2174/156727008786242537

Publication date: November 1, 2008

More about this publication?
  • Vascular Disease Prevention publishes reviews as well as original papers to update all those concerned with this topic at the clinical or scientific level. In addition to clinically relevant topics, we consider reviews and original papers dealing with the more scientific aspects of vascular disease prevention. This includes the evaluation of emerging vascular risk factors, research dealing with the pathogenesis of atherosclerosis and the investigation of new treatment options both at the clinical and scientific level (e.g. epidemiology, patient-based studies, experimental models, in vitro experiments or molecular research). Therefore, another function of Vascular Disease Prevention is to bridge the gap between clinical practice and ongoing laboratory-based research.

    In particular, we welcome critical reviews and comments on recent trials. This is a topic that requires regular updates because of the large number of trials published every year.

    Debates are encouraged in the correspondence section of this journal.
    The editorial structure of Vascular Disease Prevention is set up with the aim of dealing with the submitted material as rapidly as possible. Specialist editors will provide a more expert and rapid assessment unlike a more centralized editorial structure.
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