Assessment of Human Cerebral
Ischemia Using Magnetic
Resonance Imaging Techniques

By Vincent Thijs
September 2004
Leuven University Press
ISBN: 9058673847
155 pages, Illustrated, 6 " x 9"


This is a Ph.D. dissertation. A stroke is defined by the World Health Organization as a syndrome consisting of the rapid onset of a focal cerebral deficit of vascular origin lasting more than 24 hours. Three pathological subtypes exist: ischemic stroke, stroke, intracerebral hemorrhage and subarachnoid hemorrhage. Ischemic strokes are the most frequent (about 80% in white populations) of these subtypes.

Although well-known acquired risk factors are involved in this complex disease, genetic factors predisposing for stroke have recently been found. Even single gene mutations can cause recurrent ischemic stroke and vascular dementia. Acquired risk factors for stroke are hypertension, diabetes, lipid disorders, smoking and atrial fibrillation.

Ischemic stroke is a heterogeneous disorder with respect to etiology and prognosis. About 20% of strokes arise from cardiac emboli, about 25% are caused by obstructions of small perforating vessels, and 20% by atherosclerosis of precerebral or intracerebral vessels. Atherosclerosis of intracranial vessels remains a therapeutic challenge. A large proportion of strokes remain unexplained. More infrequent diseases like carotid dissection or coagulopathies account for about 5% of all strokes.

Sometimes two concurrent etiologies are found, especially among the elderly. The prognosis after stroke is variable. Stroke symptoms can resolve within seconds or cause death or severe permanent disability. Most stroke victims exhibit permanent symptoms which can consist of hemiplegia, gait disturbance, incontinence, cognitive disturbance or vision disturbances. The relationship between stroke, cognitive impairment, and frank dementia is still incompletely understood as is the relationship between vascular disturbance and neurodegenerative diseases.

Contents include: Part 1 Study of the clinical and prognostic value of DWI, Part 2 Evaluation of the validity of the PWI technique and optimalization of the technique, Part 3 Investigation of the use of DWI and PWI as a tool to select candidates for thrombolysis with MR beyond the accepted time window of 0-3 hrs.

Acta Biomedica Lovaniensia No. 314

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