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CT Perfusion in Acute Stroke

Penumbra and core volume mapping for thrombectomy decisions.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Radyoloji department. Book Appointment →

What is CT Perfusion in Acute Stroke?

CT perfusion (CTP) is a dynamic post-contrast acquisition that measures cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and time to maximum (Tmax), allowing differentiation of irreversibly damaged ischemic core from salvageable penumbra in acute ischemic stroke.

DEFUSE-3 and DAWN trial criteria use CTP-derived volumes (core <70 mL, mismatch ratio >1.8 and mismatch volume >15 mL) to select extended window patients (6-24 hours) for mechanical thrombectomy with significant clinical benefit.

Symptoms

Acute focal neurological deficit (FAST positive)
Last-known-well time within 24 hours
Suspected large vessel occlusion (NIHSS ≥6)
Wake-up stroke or unknown onset
Recurrent fluctuating neurological symptoms

Risk Factors

Atrial fibrillation
Carotid stenosis
Hypertension and diabetes
Smoking and obesity
Family history of stroke
Hypercoagulable disorders
Prior TIA or stroke

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Sudden weakness, speech disturbance or vision loss
  • Acute neurological symptoms within 24 hours of onset
  • Wake-up stroke with last-known-well outside 4.5 hours
  • Severe stroke with potential large vessel occlusion
  • Recurrent or worsening focal neurological deficits

Treatment Methods

01
Non-contrast CT to exclude hemorrhage (first step)
02
CT angiography for large vessel occlusion identification
03
CT perfusion in 6-24 hour window for thrombectomy candidates
04
Automated post-processing software (RAPID, Olea) for core/penumbra volumes
05
IV thrombolysis (tPA or tenecteplase) within 4.5 hours if eligible
06
Mechanical thrombectomy for proximal anterior circulation occlusions
07
Stroke unit admission with secondary prevention initiation

Which Department to Visit?

You can visit our Radyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.