engleski

What can we learn about ischemic penumbra on magnetic resonance imaging following thrombolytic treatment of stroke?

The concept of ischemic penumbra as critically hypoperfused and functionally impaired but not irreversibly damaged tissue surrounding the ischemic core was introduced more than 20 years ago. This tissue has a complex and dynamic characteristics with different thresholds for hypoxic stress and injury specific to tissue site, cell type, molecular pathway or gene expression, and depends of collateral or residual flow and reperfusion. The pathophysiology and reperfusion possibilities of ischemic penumbra have been investigated mostly by use of different neuroimaging methods in order to find possible ways of saving as many damaged tissue as possible. Most of the studies analyzed penumbra immediately or up to 9 h after onset of vessel occasion, with different conclusions considering its shape, characteristics, and prognostic as well as reperfusion possibilities. We retrospectively analyzed post-treatment MRI's of our 15 patients who were treated with thrombolytic therapy for acute ischemic stroke. In our investigation we compared pre-treatment images, and clinical characteristics with clinical outcome and MRI findings performed 10-30 days after treated stroke. In spite of the fact that the investigation has been done retrospectively as well as on very small number of patients, our results could confirm the new concept of penumbra considering its shape after reperfusion, as well as raise some new questions about clinical rele vance of penumbral tissue.

stroke, penumbra, thrombolytic treatment, MRI

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