Smadzeņu perfūzija akūta insulta pacientiem ar aterosklerotiskām izmaiņām brahiocefālos asinsvados

Translated title of the contribution: Brain Perfusion in Acute Stroke Patients with Atherosclerotic Changes in Brachiocephalic Blood Vessels

Research output: Types of ThesisDoctoral Thesis


The doctoral thesis “Brain perfusion in acute stroke patients with atherosclerotic changes in brachiocephalic blood vessels” is devoted to one of the most topical issues today - the diagnosis of cerebral infarction in acute period. Acute stroke is one of the major sources of mortality, dementia and disability in the world. The thesis show mainly analysis of the three current incompletely researched problems in early acute stroke patients: changes in blood vessels - atherosclerosis and collateral blood supply effect on brain perfusion patterns, as well as computed tomography (CT) perfusion threshold values in differentiation of reversible and irreversible ischemic lesions and analysis of multimodal CT methodology role in acute stroke diagnostic management and treatment selection, by using early radiological parameters. While non-enhanced CT images show normal finding - quantitative CT perfusion measurements show early specific ischemic changes in the brain tissue at the time of acute stroke. The aim was to characterize brain perfusion in acute ischemic stroke patients with and without atherosclerotic changes in brachiocephalic blood vessels using multimodal CT imaging method, and to determine its role in the overall diagnostic algorithm and treatment decisions. Investigational multimodal CT protocol data were analyzed in 297 patients with acute neurological deficit within 9 hours from symptom onset. Quantitative CT perfusion measurements revealed that the main parameters determining the reversible perfusion deficit are: cerebral blood volume and cerebral blood flow mismatch in combination with prolonged blood mean transit time at penumbra area. Irreversible lesion is defined by cerebral blood volume, cerebral blood flow and mean transit time congruency in necrosis or core area. Relative perfusion parameter values have additional diagnostic value for definition between reversible and irreversible lesions. CT perfusion ASPECTS scale is used as a potential marker for a favorable clinical outcome, which is significantly correlated with neurological (NIHSS scale), and functional deficit (mRS scale) values. Our results indicate that the use of multimodal CT imaging, non-contrast CT, CT angiography and CT perfusion, makes possible to differentiate between brain ischemic lesions in early acute cerebral stroke, to determine perfusion changes due to atherosclerotic changes in blood vessels, occlusion site and presence of collateral blood flow, and to assess diagnostic capabilities in early prognosis of potential clinical outcome.
Translated title of the contributionBrain Perfusion in Acute Stroke Patients with Atherosclerotic Changes in Brachiocephalic Blood Vessels
Original languageLatvian
  • Krūmiņa, Gaida, First/Primary/Lead supervisor
Place of PublicationRiga
Publication statusPublished - 2014


  • Doctoral Thesis

Field of Science*

  • 3.1 Basic medicine
  • 3.2 Clinical medicine

Publication Type*

  • 4. Doctoral Thesis


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