The Ischemic Penumbra: Identification, Evolution and Treatment Concepts

作者: Marc Fisher

DOI: 10.1159/000074790

关键词: Irreversible injuryIschemiaInfarctionTherapeutic modalitiesIntensive care medicineStroke patientPenumbraStrokeMedicineIschemic regionNeurologyClinical neurologyCardiology and Cardiovascular Medicine

摘要: The concept of the ischemic penumbra is an important one for both basic investigators cerebral ischemia and clinicians who treat stroke patients. has been defined in a variety ways, but most clinically relevant definition that portion territory still potentially salvageable, if appropriate treatment given. Currently, three main challenges persist those interested concept: how can this region be accurately identified patients, what mechanisms cell death are progression from towards irreversible injury therapeutic modalities likely to impede development infarction? Much information regarding each these topics become available recently will focus paper.

参考文章(29)
Maria Ankarcrona, Jeannette M. Dypbukt, Emanuela Bonfoco, Boris Zhivotovsky, Sten Orrenius, Stuart A. Lipton, Pierluigi Nicotera, Glutamate-induced neuronal death: A succession of necrosis or apoptosis depending on mitochondrial function Neuron. ,vol. 15, pp. 961- 973 ,(1995) , 10.1016/0896-6273(95)90186-8
Peter D. Schellinger, Jochen B. Fiebach, Olav Jansen, Peter A. Ringleb, Alexander Mohr, Thorsten Steiner, Sabine Heiland, Stefan Schwab, Olivia Pohlers, Henning Ryssel, Berk Orakcioglu, Klaus Sartor, Werner Hacke, Stroke magnetic resonance imaging within 6 hours after onset of hyperacute cerebral ischemia Annals of Neurology. ,vol. 49, pp. 460- 469 ,(2001) , 10.1002/ANA.95
François Le Doze, Fausto Viader, Jean Michel Derlon, Jean Claude Baron, Gilles Marchal, Vincent Beaudouin, Patrice Rioux, Vincent de la Sayette, Prolonged Persistence of Substantial Volumes of Potentially Viable Brain Tissue After Stroke A Correlative PET-CT Study With Voxel-Based Data Analysis Stroke. ,vol. 27, pp. 599- 606 ,(1996) , 10.1161/01.STR.27.4.599
G. Schlaug, A. Benfield, A. E. Baird, B. Siewert, K. O. Lovblad, R. A. Parker, R. R. Edelman, S. Warach, The ischemic penumbra Operationally defined by diffusion and perfusion MRI Neurology. ,vol. 53, pp. 1528- 1537 ,(1999) , 10.1212/WNL.53.7.1528
Kwang Ho Lee, Soo-Jin Cho, Hong Sik Byun, Dong Gyu Na, Nak-Cheon Choi, Soo Joo Lee, In-Seon Jin, Te Gyu Lee, Chin-Sang Chung, Triphasic Perfusion Computed Tomography in Acute Middle Cerebral Artery Stroke A Correlation With Angiographic Findings JAMA Neurology. ,vol. 57, pp. 990- 999 ,(2000) , 10.1001/ARCHNEUR.57.7.990
Matthias Koenig, Michael Kraus, Carmen Theek, Ernst Klotz, Walter Gehlen, Lothar Heuser, Quantitative Assessment of the Ischemic Brain by Means of Perfusion-Related Parameters Derived From Perfusion CT Stroke. ,vol. 32, pp. 431- 437 ,(2001) , 10.1161/01.STR.32.2.431
Chelsea S Kidwell, Jeffrey L Saver, James Mattiello, Sidney Starkman, Fernando Vinuela, Gary Duckwiler, Y Pierre Gobin, Reza Jahan, Paul Vespa, Mary Kalafut, Jeffry R Alger, None, Thrombolytic reversal of acute human cerebral ischemic injury shown by diffusion/perfusion magnetic resonance imaging Annals of Neurology. ,vol. 47, pp. 462- 469 ,(2000) , 10.1002/1531-8249(200004)47:4<462::AID-ANA9>3.0.CO;2-Y
KENNETH I. MAYNARD, ALFREDO QUINONES-HINOJOSA, JUNAID Y. MALEK, Neuroprotection against ischemia by metabolic inhibition revisited. A comparison of hypothermia, a pharmacologic cocktail and magnesium plus mexiletine. Annals of the New York Academy of Sciences. ,vol. 890, pp. 240- 254 ,(1999) , 10.1111/J.1749-6632.1999.TB07999.X
G. Mies, S. Ishimaru, Y. Xie, K. Seo, K.-A. Hossmann, Ischemic thresholds of cerebral protein synthesis and energy state following middle cerebral artery occlusion in rat. Journal of Cerebral Blood Flow and Metabolism. ,vol. 11, pp. 753- 761 ,(1991) , 10.1038/JCBFM.1991.132
T. Neumann-Haefelin, M. E. Moseley, G. W. Albers, New magnetic resonance imaging methods for cerebrovascular disease: emerging clinical applications. Annals of Neurology. ,vol. 47, pp. 559- 570 ,(2000) , 10.1002/1531-8249(200005)47:5<559::AID-ANA2>3.0.CO;2-S