Thank you for you videos! Great job, keep it up! What if CBF and CBV are decreased (such would be interpreted as large ischemic core) but except hyperdense middle cerebral artery sign there are no others signs of infarction on non-contrast CT ? Would patient in such a case benefit from reperfusion therapy?
Thanks, and a great question! In any case of reperfusion therapy, the onset and severity of symptoms plays a vital role as well as imaging. CT perfusion can aid in this decision, but I would be skeptical of the CT perfusion if it shows a large ischemic core but the NECT shows no ischemic changes since many errors can occur when processing the images for CTP. You could (if accessible) perform a MRI and look for diffusion/FLAIR mismatch to aid in this decision. I hope this answers your question!
