Time Is Brain—Quantified

  title={Time Is Brain—Quantified},
  author={Jeffrey L. Saver},
  • J. Saver
  • Published 1 January 2006
  • Medicine, Biology, Psychology
  • Stroke
Background and Purpose— The phrase “time is brain” emphasizes that human nervous tissue is rapidly lost as stroke progresses and emergent evaluation and therapy are required. Recent advances in quantitative neurostereology and stroke neuroimaging permit calculation of just how much brain is lost per unit time in acute ischemic stroke. Methods— Systematic literature-review identified consensus estimates of number of neurons, synapses, and myelinated fibers in the human forebrain; volume of large… 

High Variability in Neuronal Loss: Time Is Brain, Requantified

Widespread spread rates of infarct growth are observed in acute ischemic stroke because of proximal LVO with rate of neuron loss per minute ranging from <35 000 per minute in slow progressors to >27 million perminute in fast progressors, with a mean and median of 2 million and 0.9 million, respectively.

Neuroimaging in Acute Ischemic Stroke

There is an obvious need for a reliable and rapid means of detecting and diagnosing acute ischemic stroke to offer timely and appropriate treatment.

Imaging of Acute Ischemic Stroke

This review focuses on the imaging techniques used in the diagnosis and treatment of acute ischemic stroke, with an emphasis on those involving the anterior circulation.

What Makes a Positive Deviant

Positive deviance methods are utilized to guide and support ongoing institutional stroke quality improvement (QI) and identify successful outliers, the positive deviants.

Facing the Time Window in Acute Ischemic Stroke: The Infarct Core

No significant time dependency of the viability of brain tissue with embolic carotid T or M1 occlusions between 1 and 6 h after stroke onset is found.

White Matter Ischemia: Time to Begin Integrating Experimental and Clinical Data

For years this subject has been regarded and treated exclusively as a grey matter disease, and the focus of research has almost entirely been on neuronal compartment, resulting in a limited understanding of the physiopathology of acute stroke and failure in finding neuroprotective strategies able to reduce the ischemic damage to the brain parenchyma.

Imaging acute ischemic stroke.

Time and Diffusion Lesion Size in Major Anterior Circulation Ischemic Strokes

It is suggested that highly variable cerebral perfusion via the collateral circulation may primarily determine infarct growth dynamics in patients with documented internal carotid artery/middle cerebral artery occlusions within 30 hours of stroke onset.

The Acute Stroke Care Revolution: Enhancing Access to Therapeutic Advances.

Starting in late 2014, a series of randomized trials demonstrated the efficacy of clot extraction (thrombectomy) for the approximately one-third of patients with acute ischemic stroke who were deemed not eligible for tissue plasminogen activator treatment.

Aging and the human neocortex

Infarct volume as a surrogate or auxiliary outcome measure in ischemic stroke clinical trials. The RANTTAS Investigators.

Subacute CT infarct volume correlates moderately with 3-month clinical outcome as assessed by widely used neurological and functional assessment scales, and constrains the use of infarCT volume as a surrogate end point in ischemic stroke clinical trials.

Neocortical neuron number in humans: Effect of sex and age

Sex and age were the main determinants of the total number of neurons in the human neocortex, whereas body size, per se, had no influence on neuron number.

Beyond Mismatch: Evolving Paradigms in Imaging the Ischemic Penumbra With Multimodal Magnetic Resonance Imaging

There now are sufficient data to support paradigm shifts in a variety of central tenets regarding MRI and the ischemicpenumbra, including the insights that diffusion-perfusion mismatch does not optimally define the penumbra.

Mapping the Ischaemic Penumbra with PET: Implications for Acute Stroke Treatment

  • J. Baron
  • Medicine, Biology
    Cerebrovascular Diseases
  • 1999
The ischaemic penumbra has been documented in the laboratory animal as a severely hypoperfused, non-functional, but still viable cortex surrounding the irreversibly damaged ischaemic core; with

Aging of the human cerebellum: A stereological study

Cerebella from 19 normal Caucasian males, ages 19–84 years, were studied using stereological methods and a significant change was observed with age in the anterior lobe, where a selective 40% loss of both Purkinje and granule cells was found.

Topography and Temporal Evolution of Hypoxic Viable Tissue Identified by 18F-Fluoromisonidazole Positron Emission Tomography in Humans After Ischemic Stroke

These observations suggest that infarct expansion occurs at the expense of hypoxic tissue from the center to the periphery of the ischemic region in humans, similar to that seen in experimental animal models.

Hypoxic tissue in ischaemic stroke: persistence and clinical consequences of spontaneous survival.

The favourable neurological outcome associated with spontaneous survival of hypoxic tissue, even 12-48 h after stroke onset, suggests that the volume of Hypoxic tissue that progressed to infarction may represent a valuable target for therapeutic intervention.

Stereological analysis of the mediodorsal thalamic nucleus in schizophrenia: Volume, neuron number, and cell types

The hypothesis that the mediodorsal thalamic nucleus is a locus of pathology in schizophrenia is not supported, although they cannot rule out important functional or structural changes in parameters not measured.

Pathophysiological topography of acute ischemia by combined diffusion-weighted and perfusion MRI.

Analysis of the topographic concordance of PI and DWI lesions in acute stroke reveals regional PI lesions without concomitantDWI lesions, which do not necessarily progress to infarction but may suggest stroke pathogenesis and site of current arterial occlusion.