The ischemic penumbra was initially defined by Symon, Lassen and colleagues in the 1970s as an area of brain tissue with inadequate blood flow to maintain electric activity of neurons but adequate blood flow to preserve the function of the ion channels. This area of tissue, receiving enough blood to survive but not enough to function, often surrounds or abuts the irreversibly damaged core in ischemic stroke. It was shown that if blood flow could be restored to this area of marginal perfusion, the tissue could survive and function again, and growth of the core could be prevented. Based on seminal PET studies, penumbra or "penumbral tissue" eventually took on a subtly different meaning - the area of brain that is destined to progress to infarct unless blood flow is restored within a particular time window. The penumbra thus became the target for all acute stroke interventions - to preserve viability of the tissue and restore function. New imaging techniques, including diffusion and perfusion MRI and CT perfusion, were developed to rapidly identify individuals with penumbra, who were thought to be the best candidates for aggressive interventions to restore blood flow, particularly beyond the licensed time-window for IV thrombolysis. However, most clinical trials have failed to establish the usefulness of identifying candidates for treatment in this way using pre-specified protocols and primary endpoints. These trials have used different and sometimes unvalidated thresholds of hypoperfusion as well as irreversible infarct and various definitions of significant penumbra (or mismatch between irreversible infarct and hypoperfused, but salvageable tissue), and reanalysis of their data using more refined image processing showed post-hoc positivity. They have also evaluated outcome in a variety of ways, with few studies measuring the direct effect of restoring blood flow on the function of the penumbral tissue. Therefore, important remaining questions include how to define, characterize, and image the penumbra in acute stroke to achieve the greatest reliability and validity for what we want to measure, and whether this concept, so defined, provides an optimal target for stroke therapy using state-of-the-art trial design.

The Ischemic Penumbra presents the current status of concepts and research on this topic and identifies the latest methods for clinicians to quickly and efficiently recognize viable cerebral tissue for enhanced stroke management. Focusing on state-of-the-science technologies and current trends, the book examines imaging strategies utilizing PET, SP

New, exciting, and innovative advances in the field of cerebrovascular medicine continue to occur at a rapid pace. The fourth edition of Current Review of Cerebrovascular Disease provides an update on these rapidly evolving topics and a gives the reader insight into the thought-provoking issues in stroke neurology that have undergone tremendous changes during the past two years. The volume covers four main sections: basic science, diagnostics, clinical aspects, and treatment.

This fully revised edition explores the management of neurological disorders with a focus on neuroprotection, disease modification, and neuroregeneration rather than symptomatic treatment. Since the publication of the first edition, advances in biotechnology, particularly in cell and gene therapies, are reflected in this volume, as are numerous new and repurposed drugs in clinical trials. Overall, The Handbook of Neuroprotection serves as a comprehensive review of neuroprotection based on knowledge of the molecular basis of disorders of the central nervous system. In-depth and authoritative, The Handbook of Neuroprotection, Second Edition features a compendium of vital knowledge aimed at providing researchers with an essential reference for this key neurological area of study.

During the last few years, exciting new insights into mechanisms and treatment of stroke have been obtained from animal experiments. Hence, the use of animal models to induce stroke are of paramount importance as research tools. While a few articles on this topic have been published in select journals, until now there has not been a systematic tech

Provides a comprehensive summary of the current role of MR imaging in patients with ischemic stroke. Specifically designed to meet the needs of both clinicians and radiologists. Documents the MR correlates of specific stroke syndromes. Contains many high-quality illustrations.

There is now evidence that irreversible brain damage accumulates very early in the course of multiple sclerosis. This book reviews the main neurobiological, magnetic resonance imaging, and clinical aspects of the early phases of the dis ease. Mechanisms ofirreversible axonal damage and the role played by the inter action of glia and the axon are highlighted. In contrast to what was believed for a long time, the sufficient availability of oligodendrocyte precursor cells to promote remyelination in acute lesions has now been demonstrated. For reasons not understood, this remyelination process fails or does not start, particularly in the chronic stages ofthe disease. These findings emphasize the importance of the "milieu" changes induced by an inflammatory process in limiting remyelination. However, first indications are that part of this inflammatory process may have a neuroprotective effect. Pathological studies in multiple sclerosis have now clearly demonstrated that destructive processes may be followed by recovery phases in such a way that myelin may be morphologically and functionally reconstituted. These findings provide the rationale for early treatment and emphasize the importance of clinical trials in early multiple sclerosis. Early treatment is one of the most important aspects in multiple sclerosis today.

Stroke: New Insights for the Healthcare Professional: 2013 Edition is a ScholarlyEditions™ book that delivers timely, authoritative, and comprehensive information about Diagnosis and Screening. The editors have built Stroke: New Insights for the Healthcare Professional: 2013 Edition on the vast information databases of ScholarlyNews.™ You can expect the information about Diagnosis and Screening in this book to be deeper than what you can access anywhere else, as well as consistently reliable, authoritative, informed, and relevant. The content of Stroke: New Insights for the Healthcare Professional: 2013 Edition has been produced by the world’s leading scientists, engineers, analysts, research institutions, and companies. All of the content is from peer-reviewed sources, and all of it is written, assembled, and edited by the editors at ScholarlyEditions™ and available exclusively from us. You now have a source you can cite with authority, confidence, and credibility. More information is available at http://www.ScholarlyEditions.com/.