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Imaging of cerebral ischemic edema and neuronal death

Neuroradiology, 2017-06, Vol.59 (6), p.545-553 [Peer Reviewed Journal]

Springer-Verlag Berlin Heidelberg 2017 ;Neuroradiology is a copyright of Springer, 2017. ;ISSN: 0028-3940 ;EISSN: 1432-1920 ;DOI: 10.1007/s00234-017-1847-6 ;PMID: 28540400

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Title:
Imaging of cerebral ischemic edema and neuronal death
Author: von Kummer, Rüdiger ; Dzialowski, Imanuel
Subjects: Attenuation ; Blood flow ; Brain ; Brain Edema - diagnostic imaging ; Brain Edema - pathology ; Brain Edema - physiopathology ; Brain Ischemia - diagnostic imaging ; Brain Ischemia - pathology ; Brain Ischemia - physiopathology ; Capillary flow ; Cell Death ; Computed tomography ; Decisions ; Diagnosis, Differential ; Edema ; Humans ; Imaging ; Infarction ; Injuries ; Invited Review ; Ischemia ; Magnetic resonance imaging ; Medical imaging ; Medicine ; Medicine & Public Health ; Moisture content ; Neuroimaging - methods ; Neurology ; Neurons ; Neurons - pathology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Pathology ; Radiology ; Restoration ; Search engines ; Stroke ; Stroke - diagnostic imaging ; Stroke - pathology ; Stroke - physiopathology
Is Part Of: Neuroradiology, 2017-06, Vol.59 (6), p.545-553
Description: Purpose In acute cerebral ischemia, the assessment of irreversible injury is crucial for treatment decisions and the patient’s prognosis. There is still uncertainty how imaging can safely differentiate reversible from irreversible ischemic brain tissue in the acute phase of stroke. Methods We have searched PubMed and Google Scholar for experimental and clinical papers describing the pathology and pathophysiology of cerebral ischemia under controlled conditions. Results Within the first 6 h of stroke onset, ischemic cell injury is subtle and hard to recognize under the microscope. Functional impairment is obvious, but can be induced by ischemic blood flow allowing recovery with flow restoration. The critical cerebral blood flow (CBF) threshold for irreversible injury is ~15 ml/100 g × min. Below this threshold, ischemic brain tissue takes up water in case of any residual capillary flow (ionic edema). Because tissue water content is linearly related to X-ray attenuation, computed tomography (CT) can detect and measure ionic edema and, thus, determine ischemic brain infarction. In contrast, diffusion-weighted magnetic resonance imaging (DWI) detects cytotoxic edema that develops at higher thresholds of ischemic CBF and is thus highly sensitive for milder levels of brain ischemia, but not specific for irreversible brain tissue injury. Conclusion CT and MRI are complimentary in the detection of ischemic stroke pathology and are valuable for treatment decisions.
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
Language: English
Identifier: ISSN: 0028-3940
EISSN: 1432-1920
DOI: 10.1007/s00234-017-1847-6
PMID: 28540400
Source: AUTh Library subscriptions: ProQuest Central
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Imaging of cerebral ischemic edema and neuronal death

Springer-Verlag Berlin Heidelberg 2017 ;Neuroradiology is a copyright of Springer, 2017. ;ISSN: 0028-3940 ;EISSN: 1432-1920 ;DOI: 10.1007/s00234-017-1847-6 ;PMID: 28540400

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