Ghost infarct core
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At the time the article was created Dimitrios Toumpanakis had no recorded disclosures.
View Dimitrios Toumpanakis's current disclosuresAt the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.
View Rohit Sharma's current disclosures- GIC
Ghost infarct core refers to the phenomenon that CT perfusion may overestimate infarct core on admission, especially in the early time window of a stroke, by predicting lesion in areas that will not show infarct on follow-up imaging 1. This mismatch is defined as the initial infarct core minus final infarct (>10 mL) 3. Ghost infarct core may occur in up to 10% of patients selected for endovascular clot retrieval, particularly in younger patients 3.
This is a clinically important concept because selecting patients for reperfusion therapies based on the CT perfusion estimated penumbra may deny treatment to patients who might still benefit from reperfusion. Since overestimation of the infarct core by CT perfusion seems to be time-dependent, penumbra especially among early arrivers should be interpreted cautiously 2.
References
- 1. Boned S, Padroni M, Rubiera M, Tomasello A, Coscojuela P, Romero N, Muchada M, Rodríguez-Luna D, Flores A, Rodríguez N, Juega J, Pagola J, Alvarez-Sabin J, Molina CA, Ribó M. Admission CT perfusion may overestimate initial infarct core: the ghost infarct core concept. (2017) Journal of neurointerventional surgery. doi:10.1136/neurintsurg-2016-012494 - Pubmed
- 2. Sivan‐Hoffmann R, Saban M, Buxbaum C, Srour F, Sprecher E, Eran A, Abergel E, Telman G. Infarct Core Reliability by CT Perfusion is a Time‐Dependent Phenomenon. (2020) Journal of Neuroimaging. 30 (2): 240. doi:10.1111/jon.12692
- 3. Ospel J, Rex N, Rinkel L et al. Prevalence of “Ghost Infarct Core” After Endovascular Thrombectomy. AJNR Am J Neuroradiol. 2024. doi:10.3174/ajnr.a8113 - Pubmed
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