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(Stroke. 2004;35:2657.)
© 2004 American Heart Association, Inc.

Articles

Current Concepts of the Ischemic Penumbra

Introduction

From the University of Massachusetts Medical School (M.F.), Worcester, Mass; and the University of Miami Medical School (M.G.), Miami, Fla.

Correspondence to Dr Marc Fisher, Department of Neurology, University of Massachusetts, UMASS/Memorial Healthcare, 119 Belmont Street, Worcester, MA 01605–2982. Email fisherm@ummhc.org

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The concept of the ischemic penumbra is now more than 20 years old and has become increasingly important as the potential for treating acute ischemic stroke expands. Many definitions of the ischemic penumbra have been proposed in relationship to the modalities used to derive information about the presence and evolution of this ischemic region.¹ Perhaps the simplest but most clinically and pharmacologically relevant definition is "ischemic tissue potentially destined for infarction but not yet irreversibly injured and the target of acute therapies."² The reliable detection of the ischemic penumbra would provide much important information for both clinicians and researchers. Imaging provides a window for the potential identification of the ischemic penumbra and much effort has been and will be expended regarding the development of reliable imaging techniques for penumbral identification. Positron emission tomography (PET) is the oldest imaging technique employed for penumbral detection in patients and is currently considered the gold standard.³ PET provides spatially detailed, highly quantifiable data that is highly accurate. Unfortunately, PET availability is limited to a few centers and ease of patient access is quite limited during the acute phase of stroke, when information about the penumbra is most critical. Diffusion/perfusion magnetic resonance imaging (MRI) is increasingly available at major hospitals worldwide for the acute evaluation of stroke patients. Many groups have evaluated the utility of the diffusion/perfusion mismatch for identifying stroke patients more likely to respond to acute therapy and have shown promising results.^4,5 It is, however, widely recognized that the diffusion/perfusion mismatch is at . . . [Full Text of this Article]

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