Refining the Ischaemic Penumbra with Topography

10 minute interview with Thanh Phan; Monash University, Department of Medicine. 40 years and zero progress has been made in preventing this damage.  Absolute incompetence from the WSO and their International Journal of Stroke. Give me ten years and money and I can get this solved.
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It has been forty years since the ischaemic penumbra was first conceptualised through work on animal models. The topography of penumbra has been portrayed as an infarcted core surrounded by penumbral tissue and an extreme rim of oligaemic tissue. In the paper‘Refining the Ischaemic Penumbra with Topography’ first Author Thanh Phan et al reviewed the understanding of the topography of the ischaemic penumbra from the initial experimental animal models to current developments with neuroimaging which have helped to further define the temporal and spatial evolution of the penumbra and refine our knowledge.  I’m Carmen Lahiff-Jenkins, Managing Editor of the International Journal of Stroke and I spoke to Dr Phan. The International Journal of Stroke is the flagship publication of the World Stroke Organization  Link to article.

Refining the ischemic penumbra with topography

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Tharani Thirugnanachandran, Henry Ma, Shaloo Singhal, ...

First Published November 15, 2017 Review Article

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Abstract

It has been 40 years since the ischemic penumbra was first conceptualized through work on animal models. The topography of penumbra has been portrayed as an infarcted core surrounded by penumbral tissue and an extreme rim of oligemic tissue. This picture has been used in many review articles and textbooks before the advent of modern imaging. In this paper, we review our understanding of the topography of the ischemic penumbra from the initial experimental animal models to current developments with neuroimaging which have helped to further define the temporal and spatial evolution of the penumbra and refine our knowledge. The concept of the penumbra has been successfully applied in clinical trials of endovascular therapies with a time window as long as 24 h from onset. Further, there are reports of “good” outcome even in patients with a large ischemic core. This latter observation of good outcome despite having a large core requires an understanding of the topography of the penumbra and the function of the infarcted regions. It is proposed that future research in this area takes departure from a time-dependent approach to a more individualized tissue and location-based approach.