Time is brain. How fast an occluded cerebral artery can be reopened is directly related to how many brain cells can be saved. The identification of a tissue window as indicated by the presence of a penumbra on multimodality imaging study has opened the time window of treatment to 24 hours after the onset.1 From 2019 to 2022, the issue of direct intra-arterial (IA) mechanical thrombectomy (MT) is non-inferior to bridging therapy or not has been settled.2 Bridging therapy may have slight advantage in re-opening the occluded arteries than direct IA MT.3 Recently published data on IA MT to treat acute ischaemic stroke (AIS) from a large vessel occlusion but with a low Alberta Stroke Programme Early CT (ASPECT) score indicated that in these patients, performing a multimodality imaging study may not be necessary. Multimodality imaging study including MRI of head, MRA of head and neck and magnetic resonance perfusion (MRP) of head or CT of head, CTA of head and neck and CT perfusion (CTP) of head are must-to-do tests when evaluating patients with AIS with an onset time between 6 and 24 hours in current clinical practice. This practice was based on the results of Clinical Mismatch in the Triage of Wake Up and Late Presenting Strokes Undergoing Neurointervention With Trevo (DAWN)4 and Endovascular Therapy Following Imaging Evaluation for …

中文翻译：

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治疗LVO型急性缺血性脑卒中时，时间窗优先于组织窗

时间就是大脑。闭塞的脑动脉重新开通的速度与能挽救多少脑细胞直接相关。多模态成像研究中存在半影所表明的组织窗口的识别将治疗的时间窗口打开至发病后 24 小时。1 从 2019 年到 2022 年，直接动脉内 (IA) 机械血栓切除术的问题(MT) 是否不劣于桥接疗法是否已定论。2 桥接疗法在重新开放闭塞动脉方面可能比直接 IA MT 稍有优势。3 最近发表的 IA MT 治疗急性缺血性卒中 (AIS) 的数据来自大血管闭塞但阿尔伯塔中风计划早期 CT (ASPECT) 评分较低的患者表明，在这些患者中可能不需要进行多模态成像研究。多模态影像研究包括头部MRI、头颈部MRA、头部磁共振灌注（MRP）或头部CT、头颈部CTA、头部CT灌注（CTP）是评估患者时必须要做的检查目前的临床实践中，AIS 的发病时间为 6 至 24 小时。这一实践是基于在接受 Trevo (DAWN)4 神经干预和血管内治疗后对醒来和迟发中风进行分类的临床不匹配结果……