2. Time Is Brain and Brain Is Flow!

  1. Andrei V Alexandrov

Published Online: 1 JUL 2013

DOI: 10.1002/9781118583906.ch2

Neurovascular Examination: The Rapid Evaluation of Stroke Patients Using Ultrasound Waveform Interpretation

Neurovascular Examination: The Rapid Evaluation of Stroke Patients Using Ultrasound Waveform Interpretation

How to Cite

Alexandrov, A. V. (ed) (2013) Time Is Brain and Brain Is Flow!, in Neurovascular Examination: The Rapid Evaluation of Stroke Patients Using Ultrasound Waveform Interpretation, John Wiley & Sons Ltd, Oxford, UK. doi: 10.1002/9781118583906.ch2

Editor Information

  1. University of Alabama at Birmingham, Birmingham, Alabama, United States

Publication History

  1. Published Online: 1 JUL 2013
  2. Published Print: 22 JUL 2013

ISBN Information

Print ISBN: 9781405185301

Online ISBN: 9781118583906

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Keywords:

  • stroke;
  • thrombolysis;
  • transcranial Doppler;
  • carotid duplex;
  • occlusion;
  • treatment;
  • outcome

Summary

The “Time is Brain!” mantra emerged from observations of the natural history of stroke and overall time-sensitive efficacy of reperfusion therapies. Multimodal brain imaging unveils the heterogeneity of penumbral patterns and ischemic core expansions. The time course of cerebral ischemia is blood flow-dependent and the “time is brain” relationship is not linear. We group patients with heterogeneous stroke mechanisms into specific time frames not because of a uniform pathobiological time dependency but because the earlier the patient presents and is treated, the greater the chance that reperfusion therapy will work. Structured case-based problem solving illustrates how to perform focused neurological and vascular assessments with ultrasound and how to integrate this information in the hyperacute phase with other imaging modalities to aid reperfusion therapies.