Written by physicians from the Massachusetts General Hospital and faculty from the Harvard Medical School, the book distills years of experience in the day-to-day management of acute stroke patients, as well as leading-edge basic and clinical research, into a practical guide. With the growing awareness that modern CT and MR imaging can meaningfully improve the outcome of the acute stroke patient, this book provides the practical information to advance the capacities of providers in delivering the most advanced care for this disease.

1;Contents;6 2;PART I Fundamentals of Acute Ischemic Stroke;12 2.1;1 Ischemic Stroke: Basic Pathophysiology and Neuroprotective Strategies --- Aneesh B. Singhal, Eng H. Lo,Turgay Dalkara,Michael A. Moskowitz;12 2.1.1;1.1 Introduction;12 2.1.2;1.2 Mechanisms of Ischemic Cell Death;12 2.1.3;1.3 Grey Matter Versus White Matter Ischemia;19 2.1.4;1.4 The Neurovascular Unit;19 2.1.5;1.5 Neuroprotection;21 2.1.6;1.6 Stroke Neuroprotective Clinical Trials: Lessons from Past Failures;21 2.1.7;1.7 Identifying the Ischemic Penumbra;23 2.1.8;1.8 Combination Neuroprotective Therapy;24 2.1.9;1.9 Ischemic Pre-conditioning;24 2.1.10;1.10 Nonpharmaceutical Strategies for Neuroprotection;25 2.1.11;1.11 Prophylactic and Long-term Neuroprotection;27 2.1.12;1.12 Conclusion;27 2.1.13;References;28 2.2;2 Causes of Ischemic Stroke --- W.J. Koroshetz, R.G.González;38 2.2.1;2.1 Introduction;38 2.2.2;2.2 Key Concept: Core and Penumbra;39 2.2.3;2.3 Risk Factors;41 2.2.4;2.4 Primary Lesions of the Cerebrovascular System;42 2.2.5;2.5 Primary Cardiac Abnormalities;44 2.2.6;2.6 Embolic Stroke;46 2.2.7;2.7 Lacunar Strokes;48 2.2.8;2.8 Other Causes of Stroke;50 2.2.9;2.9 Conclusion;51 3;PART II Imaging of Acute Ischemic Stroke;52 3.1;3 Unenhanced Computed Tomography --- Erica C.S.Camargo,Guido González, R. Gilberto González,Michael H. Lev;52 3.1.1;3.1 Introduction;52 3.1.2;3.2 Technique;53 3.1.3;3.3 Physical Basis of Imaging Findings;56 3.1.4;3.4 Optimal Image Review;57 3.1.5;3.5 CT Early Ischemic Changes: Detection and Prognostic Value;59 3.1.6;3.6 ASPECTS;61 3.1.7;3.7 Conclusion;65 3.1.8;References;65 3.2;4 Stroke CT Angiography (CTA) --- Shams Sheikh, R. Gilberto González, Michael H. Lev;68 3.2.1;4.1 Introduction;68 3.2.2;4.2 Background -General Principles of CTA;70 3.2.3;4.3 CTA Protocol for Acute Stroke;75 3.2.4;4.4 CTA Protocol for Acute Stroke;88 3.2.5;4.5 Accuracy and Clinical Utility of CTA in Acute Stroke;90 3.2.6;4.6 Future Directions;94 3.2.7;4.7 Conclusion;94 3.2.8;References;94 3.3;5 CT Perfusion (CTP) --- Sanjay K. Shetty,Michael H. Lev;98 3.3.1;5.1 Introduction;98 3.3.2;5.2 CTP Technical Considerations;99 3.3.3;5.3 Comparison with MR-PWI;102 3.3.4;5.4 CTP:General Principles;103 3.3.5;5.5 CTP Theory and Modeling;103 3.3.6;5.6 CTP Post-Processing;105 3.3.7;5.7 Clinical Applications of CTP;107 3.3.8;5.8 CTP Interpretation: Infarct Detection with CTA-SI;107 3.3.9;5.9 CTP Interpretation:Ischemic Penumbra and Infarct Core;112 3.3.10;5.10 Imaging Predictors of Clinical Outcome;118 3.3.11;5.11 Experimental Applications of CTP in Stroke;118 3.3.12;5.12 Conclusion;119 3.3.13;References;119 3.4;6 Conventional MRI and MR Angiography of Stroke --- David Vu, R.Gilberto González,Pamela W. Schaefer ;125 3.4.1;6.1 Conventional MRI and Stroke;125 3.4.2;6.2 MR Angiogram and Stroke;131 3.4.3;References;145 3.5;7 Diffusion MR of Acute Stroke --- Pamela W. Schaefer,A. Kiruluta, R. Gilberto González;148 3.5.1;7.1 Introduction;148 3.5.2;7.2 Basic Concepts/Physics of Diffusion MRI;148 3.5.3;7.3 Diffusion MR Images for Acute Stroke;153 3.5.4;7.4 Theory for Decreased Diffusion in Acute Stroke;153 3.5.5;7.5 Time Course of Diffusion Lesion Evolution in Acute Stroke;154 3.5.6;7.6 Reliability;156 3.5.7;7.7 Reversibility of DWI Stroke Lesions;159 3.5.8;7.8 Prediction of Hemorrhagic Transformation;161 3.5.9;7.9 Diffusion Tensor Imaging;164 3.5.10;7.10 Correlation with Clinical Outcome;168 3.5.11;7.11 Stroke Mimics;168 3.5.12;7.12 Nonischemic Lesions with No Acute Abnormality on Routine or Diffusion-Weighted Images;168 3.5.13;7.13 Syndromes with Reversible Clinical Deficits that may have Decreased Diffusion;168 3.5.14;7.14 Vasogenic Edema Syndromes;170 3.5.15;7.15 Other Entities with Decreased Diffusion;173 3.5.16;7.16 Venous Infarction;174 3.5.17;7.17 Conclusion;175 3.5.18;References;176 3.6;8 Perfusion MRI of Acute Stroke --- Pamela W. Schaefer,William A.Copen, R. Gilberto González;181 3.6.1;8.1 Introduction;181 3.6.2;8.2 Dynamic Susceptibility Contrast Imaging;182 3.6.3;8.3