Overestimation of core infarct by computed tomography perfusion in the golden hour

Brain Circulation

关键词: acute ischemic stroke;    cerebral blood flow;    computed tomography perfusion;    endovascular treatment;    ghost core infarct;   

DOI  :  10.4103/bc.bc_7_20

来源: DOAJ

【 摘 要 】

A nonagenarian patient developed a right middle cerebral artery syndrome during recovery after a right internal carotid artery (ICA) balloon angioplasty. Emergent head computed tomography (CT) revealed no acute ischemic changes; CT angiography (CTA) and CT perfusion (CTP) demonstrated a right ICA occlusion with a large right hemispheric predicted core infarct by cerebral blood flow thresholds and minimal mismatch volume. She underwent complete reperfusion in <45 min from symptom onset. Magnetic resonance imaging brain obtained within 48 h showed a decreased infarct volume as that estimated by CTP. This case emphasizes the limitations of estimating the ischemic core with CTP in the golden hour with ultra-early reperfusion and suggests that CTP thresholds should not be used to exclude patients from treatment in the very early time window.

【 授权许可】

Unknown