Usefulness of triphasic perfusion computed tomography for intravenous thrombolysis with tissue-type plasminogen activator in acute ischemic stroke.

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Abstract
COMPUTED tomography (CT) is widely used in patients with acute ischemic stroke to exclude acute hemorrhage or other diseases mimicking ischemia (tumor and subdural hematoma) when antithrombotic therapy is considered. Perfusion deficit and collateral blood flow are the important factors associated with the safety and efficacy of thrombolytic therapy for acute middle cerebral artery (MCA) stroke.1-3 The risk of hemorrhagic transformation after recanalization of the occluded arteries by thrombolytic therapy is considered high when pretherapeutic residual cerebral blood flow is markedly reduced.4,5 However, precontrast CT cannot provide enough information about perfusion deficit and collateral circulation.