Overestimation of core infarct by computed tomography perfusion in the golden hour
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 oc...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Brain Circulation |
| Subjects: | |
| Online Access: | http://www.braincirculation.org/article.asp?issn=2394-8108;year=2020;volume=6;issue=3;spage=211;epage=214;aulast=Mendez |
| _version_ | 1818113179803189248 |
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| author | Aldo A Mendez Darko Quispe-Orozco Sudeepta Dandapat Edgar A Samaniego Emily Tamadonfar Cynthia B Zevallos Mudassir Farooqui Colin P Derdeyn Santiago Ortega-Gutierrez |
| author_facet | Aldo A Mendez Darko Quispe-Orozco Sudeepta Dandapat Edgar A Samaniego Emily Tamadonfar Cynthia B Zevallos Mudassir Farooqui Colin P Derdeyn Santiago Ortega-Gutierrez |
| author_sort | Aldo A Mendez |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-11T03:30:43Z |
| format | Article |
| id | doaj.art-c0b46342955b48b28ef29b1c6631d689 |
| institution | Directory Open Access Journal |
| issn | 2455-4626 |
| language | English |
| last_indexed | 2024-12-11T03:30:43Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Brain Circulation |
| spelling | doaj.art-c0b46342955b48b28ef29b1c6631d6892022-12-22T01:22:23ZengWolters Kluwer Medknow PublicationsBrain Circulation2455-46262020-01-016321121410.4103/bc.bc_7_20Overestimation of core infarct by computed tomography perfusion in the golden hourAldo A MendezDarko Quispe-OrozcoSudeepta DandapatEdgar A SamaniegoEmily TamadonfarCynthia B ZevallosMudassir FarooquiColin P DerdeynSantiago Ortega-GutierrezA 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.http://www.braincirculation.org/article.asp?issn=2394-8108;year=2020;volume=6;issue=3;spage=211;epage=214;aulast=Mendezacute ischemic strokecerebral blood flowcomputed tomography perfusionendovascular treatmentghost core infarct |
| spellingShingle | Aldo A Mendez Darko Quispe-Orozco Sudeepta Dandapat Edgar A Samaniego Emily Tamadonfar Cynthia B Zevallos Mudassir Farooqui Colin P Derdeyn Santiago Ortega-Gutierrez Overestimation of core infarct by computed tomography perfusion in the golden hour Brain Circulation acute ischemic stroke cerebral blood flow computed tomography perfusion endovascular treatment ghost core infarct |
| title | Overestimation of core infarct by computed tomography perfusion in the golden hour |
| title_full | Overestimation of core infarct by computed tomography perfusion in the golden hour |
| title_fullStr | Overestimation of core infarct by computed tomography perfusion in the golden hour |
| title_full_unstemmed | Overestimation of core infarct by computed tomography perfusion in the golden hour |
| title_short | Overestimation of core infarct by computed tomography perfusion in the golden hour |
| title_sort | overestimation of core infarct by computed tomography perfusion in the golden hour |
| topic | acute ischemic stroke cerebral blood flow computed tomography perfusion endovascular treatment ghost core infarct |
| url | http://www.braincirculation.org/article.asp?issn=2394-8108;year=2020;volume=6;issue=3;spage=211;epage=214;aulast=Mendez |
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