ReviewJournal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism2018
Imaging the physiological evolution of the ischemic penumbra in acute ischemic stroke.
Review in Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 100 papers.
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Who cites it
100 citing papers in PubMed.
- Deep Learning-Based Diffusion-Weighted Magnetic Resonance Imaging in the Diagnosis of Ischemic Penumbra in Early Cerebral Infarction.Contrast media & molecular imaging · 2022Trial
- Elevated brain oxygen extraction fraction measured by MRI susceptibility relates to perfusion status in acute ischemic stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2020Trial
- Self-Derived Dynamic Field Map Estimation and Correction in CEST MRI.Magnetic resonance in medicine · 2026Article
- Targeting Ferroptosis and Necroptosis to Treat Stroke.Neurochemical research · 2026Review
- Cerebral Infarction: Epidemiology, Classification, Mechanisms, Diagnosis, and Management.MedComm · 2026Review
- Understanding ischemia in children with tuberculous meningitis (iThemba): a protocol paper.BMC pediatrics · 2026Article
- Physics-informed optimization of saturation-transfer MRI protocols using non-differentiable Bloch models.Physics in medicine and biology · 2026Article
- Detection Accuracy of Ischemia and Neuroinflammation in Traumatic Brain Injury in Rats Using Amide Proton Transfer-Weighted MRI.NMR in biomedicine · 2026Article
- Effectiveness of low-tube current for reducing radiation dose in cerebral computed tomography perfusion.Archives of medical science : AMS · 2026Article
- Nanomaterial-Based Drug Delivery Systems for Ischemic Stroke: From Blood-Brain Barrier Crossing to Neuroprotection.International journal of nanomedicine · 2026Review
- pH-sensitive probes for ischemic stroke: advancing early detection and accurate grading.Frontiers in molecular biosciences · 2026Review
- Inflammation-centered neurovascular-immune-metabolic remodeling in ischemic stroke: stage-dependent mechanisms, regulated cell death, and therapeutic translation.Frontiers in immunology · 2026Review
- Mapping human cerebral blood flow with high-density, multi-channel speckle contrast optical spectroscopy.Communications biology · 2025Article
- A Method for Imaging the Ischemic Penumbra with MRI Using Intravoxel Incoherent Motion.AJNR. American journal of neuroradiology · 2025Article
- Learning-based motion artifact correction in the Z-spectral domain for chemical exchange saturation transfer MRI.Magnetic resonance in medicine · 2025Article
- MeCP2 Lactylation Protects against Ischemic Brain Injury by Transcriptionally Regulating Neuronal Apoptosis.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- The fuzzy MAD stroke conjecture, using Fuzzy C Means to classify multimodal apparent diffusion for ischemic stroke lesion stratification.Magnetic resonance imaging · 2025Article
- Amide proton transfer MRI may reflect effective reperfusion and predict functional outcomes in patients with ischemic stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2025Article
- Article
- Blood-brain barrier breakdown in brain ischemia: Insights from MRI perfusion imaging.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Review
40 more citing papers are in PubMed but not listed here.
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Authors and funding
4 authors.
Funding
Abstract
We review the hemodynamic, metabolic and cellular parameters affected during early ischemia and their changes as a function of approximate cerebral blood flow ( CBF) thresholds. These parameters underlie the current practical definition of an ischemic penumbra, namely metabolically affected but still viable brain tissue. Such tissue is at risk of infarction under continuing conditions of reduced CBF, but can be rescued through timely intervention. This definition will be useful in clinical diagnosis only if imaging techniques exist that can rapidly, and with sufficient accuracy, visualize the existence of a mismatch between such a metabolically affected area and regions that have suffered cell depolarization. Unfortunately, clinical data show that defining the outer boundary of the penumbra based solely on perfusion-related thresholds may not be sufficiently accurate. Also, thresholds for CBF and cerebral blood volume ( CBV) differ for white and gray matter and evolve with time for both inner and outer penumbral boundaries. As such, practical penumbral imaging would involve parameters in which the physiology is immediately displayed in a manner independent of baseline CBF or CBF threshold, namely pH, oxygen extraction fraction ( OEF), diffusion constant and mean transit time ( MTT). Suitable imaging technologies will need to meet this requirement in a 10-20 min exam.
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