We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Refining the ischemic penumbra with topography.
- Authors
Thirugnanachandran, Tharani; Ma, Henry; Singhal, Shaloo; Slater, Lee-Anne; Davis, Stephen M.; Donnan, Geoffrey A.; Phan, Thanh
- Abstract
It has been 40 years since the ischemic penumbra was first conceptualized through work on animal models. The topography of penumbra has been portrayed as an infarcted core surrounded by penumbral tissue and an extreme rim of oligemic tissue. This picture has been used in many review articles and textbooks before the advent of modern imaging. In this paper, we review our understanding of the topography of the ischemic penumbra from the initial experimental animal models to current developments with neuroimaging which have helped to further define the temporal and spatial evolution of the penumbra and refine our knowledge. The concept of the penumbra has been successfully applied in clinical trials of endovascular therapies with a time window as long as 24 h from onset. Further, there are reports of “good” outcome even in patients with a large ischemic core. This latter observation of good outcome despite having a large core requires an understanding of the topography of the penumbra and the function of the infarcted regions. It is proposed that future research in this area takes departure from a time-dependent approach to a more individualized tissue and location-based approach.
- Subjects
ISCHEMIA; TISSUES; ANIMAL models in research; INFARCTION; BRAIN imaging
- Publication
International Journal of Stroke, 2018, Vol 13, Issue 3, p277
- ISSN
1747-4930
- Publication type
Article
- DOI
10.1177/1747493017743056