Role of CT Perfusion in Identifying the Core and the Potentially Salvageable Penumbra in Patients with Acute Non Haemorrhagic Stroke - Experience at Tertiary Care Center

OBJECTIVESTo evaluate the role of CT Perfusion in Identifying the core and the potentially salvageable penumbra in brain infarcts by observing perfusion maps (CBV, CBF and MTT). Also to identify patients who would benefit from reperfusion therapy and to evaluate the feasibility of identifying the penumbra on noncontrast CT vide comparison with perfusion maps. MATERIALS AND METHODSA prospective study of 50 patients who presented with acute onset neurological deficit within 6 hours of symptom onset and in whom initial NCCT revealed no evidence of cerebral hemorrhage; evaluated with CT Perfusion was done at tertiary care center in 1 calender year 2014. OBSERVATIONSIn our study, about 68 percent of patients presented within 6 hours of stroke had salvagebale penumbra, were eligible for revascularization therapy. HU less than 25 on NECT significantly correlated with infract core but not with presence of Penumbra. Presence of penumbra cannot be predicted from NECT ASPECT and CBV ASPECT Score. RESULTS AND CONCLUSIONCT Perfusions study being easily available, faster and cost effctive modality to identfy patients of acute ischemic strokes having salvagable penumbra for which further can be subjected to revasculrization therapy. It is strongly recommended that CT Perfusion should be made an integral part of acute non-haemorrhagic stroke management protocol, wherever the facility is available.