Ischemic Core and Penumbra in Human Stroke

Abstract

Our study in acute human stroke involving MCA occlusion indicates that a severely ischemic core (CBF </=6 cm3. 100 g-1. min-1), observed between 1 to 6 hours after stroke onset, corresponds to the cerebral tissue destined to infarction. The ischemic penumbra with flow values between 7 and 20 cm3. 100 g-1. min-1 surrounding the ischemic core is very narrow. Therefore, strategies to improve the outcome of many patients with acute MCA occlusion must either include interventions to reverse the ischemic process within a few minutes of onset or increase the cerebral tolerance of ischemia and thereby prolong the potential therapeutic window.