|
Introduction
Brain infarct is the most common cause of incapacity in adults, the second cause of dementia and the second or third cause of death in developed countries. Acute brain infarct is a medical emergency potentially reversible if treated with thrombolysis in the first hours of evolution. Thrombolysis is now an approved and efficacious method of treatment for acute ischemic stroke[1] to reduce the final infarct size and improve the clinical outcome. During the first 3 hours of evolution, intravenous and/or local intra-arterial administration of plasminogen activator (tPA) can be performed. The window of time of treatment is expanded to 6 hours only with the intra-arterial super-selective route of local thrombolysis. The potentially recoverable brain tissue affected by reversible brain ischemia is known as brain penumbra. A variety of diagnostic studies are now available in the evaluation of brain infarct and in particular of potentially reversible brain ischemia, including perfusion computed tomography (CT)[2-4], magnetic resonance imaging (MRI) diffusion-perfusion[5-6], and functional neuroimaging techniques including positron emission tomography (PET)[7-8] and single-photon emission tomography (SPECT)[9-10]. Relative to the other techniques, not us much has been reported about the utility of SPECT in the evaluation of the acutely ischemic brain. The aim of this study is to report our experience with a group of patients that presented with acute brain ischemia that had a NeuroSPECT evaluation before and after intra-arterial thrombolysis and/or possible stent placement in the treatment of acute brain infarct.
|
|
