Magnetic resonance imaging in stroke 1st Edition

Stephen M Davis 2025 full version

Now available at ebookfinal.com

https://ebookfinal.com/download/magnetic-resonance-imaging-in-
stroke-1st-edition-stephen-m-davis/

★★★★★
4.6 out of 5.0 (36 reviews )

Instant PDF Access

Magnetic resonance imaging in stroke 1st Edition Stephen M
Davis Pdf Download

EBOOK

Available Formats

■ PDF eBook Study Guide Ebook

EXCLUSIVE 2025 ACADEMIC EDITION – LIMITED RELEASE

Available Instantly Access Library

We have selected some products that you may be interested in
Click the link to download now or visit ebookfinal.com
for more options!.

Handbook of Cardiovascular Magnetic Resonance Imaging 1st

Edition Gerald M. Pohost (Editor)

https://ebookfinal.com/download/handbook-of-cardiovascular-magnetic-
resonance-imaging-1st-edition-gerald-m-pohost-editor/

Mayo Clinic Guide to Cardiac Magnetic Resonance Imaging

2nd Edition Kiaran Mcgee

https://ebookfinal.com/download/mayo-clinic-guide-to-cardiac-magnetic-
resonance-imaging-2nd-edition-kiaran-mcgee/

Clinical Magnetic Resonance Imaging 3rd Edition 3 Volume

Set Robert R. Edelman

https://ebookfinal.com/download/clinical-magnetic-resonance-
imaging-3rd-edition-3-volume-set-robert-r-edelman/

Mayo Clinic Guide to Cardiac Magnetic Resonance Imaging

1st Edition P. Mcgee Kiaran

https://ebookfinal.com/download/mayo-clinic-guide-to-cardiac-magnetic-
resonance-imaging-1st-edition-p-mcgee-kiaran/
Mayo Clinic Guide to Cardiac Magnetic Resonance Imaging
2nd Edition Kiaran P. Mcgee

https://ebookfinal.com/download/mayo-clinic-guide-to-cardiac-magnetic-
resonance-imaging-2nd-edition-kiaran-p-mcgee/

Magnetic Resonance Imaging Physical Properties and

Sequence Design 2nd Edition Robert W. Brown

https://ebookfinal.com/download/magnetic-resonance-imaging-physical-
properties-and-sequence-design-2nd-edition-robert-w-brown/

Atlas of Cardiovascular Magnetic Resonance Imaging Expert

Consult Online and Print Imaging Companion to Braunwald s
Heart Disease 1e Christopher M. Kramer Md
https://ebookfinal.com/download/atlas-of-cardiovascular-magnetic-
resonance-imaging-expert-consult-online-and-print-imaging-companion-
to-braunwald-s-heart-disease-1e-christopher-m-kramer-md/

Magnetic Resonance Neurography 1st Edition Gustav (Editor)

https://ebookfinal.com/download/magnetic-resonance-neurography-1st-
edition-gustav-editor/

Magnetic Resonance in Chemistry and Medicine 1st Edition

Ray Freeman

https://ebookfinal.com/download/magnetic-resonance-in-chemistry-and-
medicine-1st-edition-ray-freeman/
Magnetic resonance imaging in stroke 1st Edition Stephen
M Davis Digital Instant Download
Author(s): Stephen M Davis; Marc Fisher; Steven Warach
ISBN(s): 9780511119804, 0511119801
Edition: 1
File Details: PDF, 24.76 MB
Year: 2003
Language: english
 Magnetic Resonance Imaging in Stroke

Magnetic resonance imaging (MRI) provides non-invasive

information about the brain’s blood flow, water movement
and biochemical abnormalities following stroke, and
advances in MRI are transforming the investigation and
treatment of cerebrovascular disease. Echoplanar techniques
with diffusion- and perfusion-weighted imaging, together
with developments in magnetic resonance spectroscopy and
angiography, are replacing CT scanning as the diagnostic
modality of choice. In this profusely illustrated book, world
leaders in these technologies review the scientific basis and
clinical applications of MRI in stroke. It will appeal to a broad
readership including stroke physicians, neurologists,
neurosurgeons, rehabilitation specialists, and others with a
clinical or research interest in cerebrovascular disease.

Stephen Davis is Professor of Neurology at the University of

Melbourne. He heads the Stroke Research Group and is
Co-Director of the Brain Imaging Laboratory at the Royal
Melbourne Hospital, where he is Director of Neurology.

Marc Fisher is Professor of Neurology at the University of

Massachusetts, and a leading authority on the use of MRI in
the evaluation of stroke therapies.

Steven Warach is Chief of the Section on Stroke Diagnostics

and Therapeutics in the Stroke Branch at NINDS, National
Institutes of Health, Bethesda, Maryland. He pioneered the
use of diffusion and perfusion MRI in the evaluation of stroke
and in clinical trials.

Cambridge Books Online © Cambridge University Press, 2009

Cambridge Books Online © Cambridge University Press, 2009
 Magnetic Resonance
Imaging in Stroke

Edited by

Stephen Davis
University of Australia, Melbourne

Marc Fisher
University of Massachusetts Memorial Medical Care, USA

Steven Warach
National Institutes of Health, Bethesda, MD, USA

Cambridge Books Online © Cambridge University Press, 2009

  
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo

Cambridge University Press

The Edinburgh Building, Cambridge  , United Kingdom
Published in the United States of America by Cambridge University Press, New York
www.cambridge.org
Information on this title: www.cambridge.org/9780521806831

© Cambridge University Press 2003

This book is in copyright. Subject to statutory exception and to the provision of

relevant collective licensing agreements, no reproduction of any part may take place
without the written permission of Cambridge University Press.

First published in print format 2003

-
isbn-13 978-0-511-54492-7 OCeISBN

-
isbn-13 978-0-521-80683-1 hardback
-
isbn-10 0-521-80683-6 hardback

Cambridge University Press has no responsibility for the persistence or accuracy of

s for external or third-party internet websites referred to in this book, and does not
guarantee that any content on such websites is, or will remain, accurate or appropriate.

Every effort has been made in preparing this book to provide accurate and up-to-date
information which is in accord with accepted standards and practice at the time of
publication. Nevertheless, the authors, editors and publishers can make no warranties
that the information contained herein is totally free from error, not least because
clinical standards are constantly changing through research and regulation. The authors,
editors and publisher therefore disclaim all liability for direct or consequential
damages resulting from the use of material contained in this book. Readers are strongly
advised to pay careful attention to information provided by the manufacturer of any
drugs or equipment that they plan to use.

Cambridge Books Online © Cambridge University Press, 2009

 Contents

List of contributors page vii

Preface xiii

1 The importance of specific diagnosis in 1

stroke patient management
John N. Fink and Louis R. Caplan

2 Limitations of current brain imaging

modalities in stroke 15
P. Alan Barber and Stephen M. Davis

3 Clinical efficacy of CT in acute cerebral

ischemia 31
Rüdiger von Kummer

4 Computerized tomographic-based 47
evaluation of cerebral blood flow
Lawrence R. Wechsler, Steven Goldstein
and Howard Yonas

5 Technical introduction to MRI 55

Rohit Sood and Michael Moseley

6 Clinical use of standard MRI 69

Brian M. Tress

7 MR angiography of the head and neck: 85

basic principles and clinical applications
Robert R. Edelman and Joel Meyer

8 Stroke MRI in intracranial hemorrhage 103

Peter D. Schellinger, Olav Jansen and
Werner Hacke

9 Using diffusion–perfusion MRI in animal 113

models for drug development
Marc Fisher

Cambridge Books Online © Cambridge University Press, 2009

vi Contents

10 Localization of stroke syndromes using 121 16 New MR techniques to select patients for 207
diffusion-weighted MR imaging (DWI) thrombolysis in acute stroke
Max Wintermark, Marc Reichhart, Vincent N. Thijs and Gregory W. Albers
Reto Meuli and Julien Bogousslavsky
17 MRI as a tool in stroke drug development 223
11 MRI in transient ischemic attacks: clinical 135 Steven Warach
utility and insights into pathophysiology
18 Magnetic resonance spectroscopy in stroke 233
Jeffrey L. Saver and Chelsea Kidwell
Dawn E. Saunders and Martin M. Brown
12 Perfusion-weighted MRI in stroke 147
19 Functional MRI and stroke 251
William A. Copen and A. Gregory Sorensen
Amy Brodtmann, Leeanne Carey and
13 Perfusion imaging with arterial spin 161 David G. Darby
labelling
David C. Alsop and John A. Detre Index 263
Colour figures between pp. 120 and 121.
14 Clinical role of echoplanar MRI in stroke 175
Stephen Davis and Mark Parsons

15 The ischemic penumbra: the evolution of

a concept 191
Geoffrey A. Donnan, Peter M. Wright,
Romesh Markus, Thanh Phan and
David C. Reutens

Cambridge Books Online © Cambridge University Press, 2009

 Contributors

Stephen M. Davis,
Department of Neurology,
Royal Melbourne Hospital,
Parkville,
Victoria 3050,
Australia

Marc Fisher,
Department of Neurology,
UMACS,
Memorial Health Care,
119 Belmont Street,
Worcester,
MA 01605,
USA

Steven Warach,
National Institutes of Health,
NINDS,
10 Center Drive,
MSC 1063, Room B1D733,
Bethesda,
MD 29892-1063,
USA

Gregory W. Albers,
Stanford Stroke Center,
Stanford University Medical Center,
Palo Alto,
CA 94394,
USA

vii

Cambridge Books Online © Cambridge University Press, 2009

viii List of contributors

David C. Alsop, Leeanne Carey,

Department of Radiology, Department of Neurology,
Beth Israel Deaconess Medical Center and Harvard Royal Melbourne Hospital,
Medical School, Parkville,
USA Victoria,
Australia
P.A. Barber,
Department of Neurology, William A. Copen,
Royal Melbourne Hospital, Department of Radiology,
University of Melbourne, Massachusetts General Hospital,
Parkville, PO Box 9657,
Victoria 3050, 55 Fruit Street,
Australia Boston,
MA 02114,
Julien Bogousslavsky, USA
Department of Neurology,
University Hospital (CHUV) BH07, David G. Darby,
1011 Lausanne, Department of Neurology,
Switzerland Royal Melbourne Hospital,
Parkville,
Amy Brodtmann, Victoria 3050,
Department of Neurology, Australia
Royal Melbourne Hospital,
Parkville, Stephen M. Davis,
Victoria 3050, Department of Neurology,
Australia Royal Melbourne Hospital,
University of Melbourne,
Martin M. Brown, Parkville,
Stroke Medicine, Victoria 3050,
Institute of Neurology, Australia
University College London,
The National Hospital for Neurology and John A. Detre,
Neurosurgery, Departments of Neurology and Radiology,
Queen Square, University of Pennsylvania Medical Center,
London, 3 W Gates,
UK 3400 Spruce Street,
Philadelphia,
Louis R. Caplan, PA 19104–4283,
Department of Neurology, USA
Beth Israel Deaconess Medical Center,
Boston, Geoffrey A. Donnan,
MA, National Stroke Research Institute,
USA Heidelberg,
Victoria,
Australia

Cambridge Books Online © Cambridge University Press, 2009

 List of contributors ix

Robert R. Edelman, Rüdiger von Kummer,

Department of Radiology, Room 5106 Department of Neuroradiology,
Evanston Hospital, University of Technology,
2650 Ridge Avenue, Fetscherstr. 74,
Evanston, Dresden,
IL 60201, Saxonia D-01307,
USA Germany

John N. Fink, Romesh Markus,

Department of Neurology, National Stroke Research Institute,
Christchurch School of Medicine, Heidelberg,
New Zealand Victoria,
Australia
Marc Fisher,
Department of Neurology, Reto Meuli,
UMACS, Department of Diagnostic and Interventional
Memorial Health Care, Radiology,
119 Belmont Street, University Hospital (CHUV) BH07,
Worcester, 1011 Lausanne,
MA 01605, Switzerland
USA
Joel Meyer,
S. Goldstein, Department of Radiology,
University of Pittsburgh Health System, Evanston Northwestern Healthcare,
Stroke Institute, Northwestern University School of Medicine,
Departments of Neurology and Neurosurgery, 2650 Ridge Avenue,
200 Lothrop Street, Evanston,
PA 15213, IL 60201
USA USA

Werner Hacke, Michael Moseley,

Department of Neurology, Department of Radiology,
University of Heidelberg, 1201 Welch Road,
Germany Stanford University,
CA 94305-5488,
Olav Jansen, USA
Department of Neuroradiology,
University of Kiel, Mark Parsons,
Germany Department of Neurology,
Royal Melbourne Hospital,
Chelsea Kidwell, University of Melbourne,
UCLA Stroke Center, Parkville,
710 Westwood Plaza, Victoria 3050,
Los Angeles, Australia
CA 90095,
USA

Cambridge Books Online © Cambridge University Press, 2009

x List of contributors

Thanh Phan, A. Gregory Sorensen,

National Stroke Research Institute, Massachusetts General Hospital,
Heidelberg, NMR Center,
Victoria, 149 13th Street,
Australia Charlestown,
MA 02129,
Marc Reichhart, USA
Department of Neurology,
University Hospital (CHUV) BH07, Vincent N. Thijs,
1011 Lausanne, Department of Neurology,
Switzerland U2 Gasthuisberg,
Herestraat 49,
David C. Reutens, 3000 Leuven,
National Stroke Research Institute, Belgium
Heidelberg,
Victoria, Brian M. Tress,
Australia The University of Melbourne Department of
Radiology,
Dawn E. Saunders, c/o Post Office,
Department of Neuroradiology, Parkville,
The National Hospital of Neurology and Victoria 3050,
Neurosurgery, Australia
Queen Square,
London, Steven Warach
UK National Institutes of Health,
NINDS,
Jeffrey L. Saver, 10 Center Drive,
UCLA Stroke Center, MSC 1063, Room B1D 733
710 Westwood Plaza, Bethesda
Los Angeles, MD 29892–1063,
CA 90095, USA
USA
Lawrence R. Wechler,
Peter D. Schellinger, University of Pittsburgh Health System,
Department of Neurology, Stroke Institute,
University of Heidelberg, Departments of Neurology and Neurosurgery,
Im Neuenheimer Feld 400, 200 Lothrop Street,
D69120 Heidelberg, PA 15213,
Germany USA

Rohit Sood, Max Wintermark,

Department of Radiology, Department of Diagnostic and Interventional
Stanford University, Radiology,
CA 94305-5488, University Hospital (CHUV) BH07,
USA 1011 Lausanne,
Switzerland

Cambridge Books Online © Cambridge University Press, 2009

 List of contributors xi

Peter M. Wright, H. Yonas,

National Stroke Research Institute, University of Pittsburgh Health System,
Heidelberg, Stroke Institute,
Victoria, Departments of Neurology and Neurosurgery,
Australia 200 Lothrop Street,
PA 15213,
USA

Cambridge Books Online © Cambridge University Press, 2009

Cambridge Books Online © Cambridge University Press, 2009
 Preface

Stroke is a leading cause of death in Western coun-

tries, with a mortality rate higher than most forms
of cancer and now the commonest cause of long-
term adult disability. Stroke diagnosis and manage-
ment were revolutionized by the widespread
introduction of computed tomographic (CT) scan-
ning in the 1970s. CT scanning sensitively excludes
cerebral hemorrhage, but early ischemic changes
can be subtle. In the first few hours after stroke
onset, when acute therapies such as thrombolysis
are being considered, CT is often normal, although
acute ischemic changes have become better recog-
nized in recent years. Conventional magnetic reso-
nance imaging (MRI) became widely available in
most countries a decade after the advent of CT
scanning, but has had a limited role in stroke diag-
nosis and management. Although MRI provides far
better imaging of posterior fossa structures and
facilitated non-invasive angiography (MRA), its
sensitivity in acute stroke is not much better than
CT. Other functional imaging techniques such as
single photon emission computed tomography
(SPECT) and positron emission tomography (PET)
have been valuable research tools, but have not
been of routine clinical use in the management of
stroke.
Since the 1990s, the increasingly widespread
availability of echoplanar MRI technology facili-
tated the introduction of diffusion-weighted
imaging (DWI), perfusion imaging (PWI) and mag-
netic resonance spectroscopy (MRS). Diffusion-
weighted imaging allows the hyperacute evaluation
of the ischemic core within minutes of stroke onset
and the distinction between acute and chronic

xiii

Cambridge Books Online © Cambridge University Press, 2009

xiv Preface

ischemic lesions. It represents an extraordinary being tested in randomized trials. A series of

advance in stroke imaging, specifically in the region chapters details the diagnostic advances facili-
of ischemic tissue that is usually destined for infarc- tated by MRA, DWI, PWI and MRS. Following a
tion. PWI provides a measure of the hypoperfused review of the pathophysiology and clinical impor-
tissue at risk, particularly in the ischemic penum- tance of the ischemic penumbra, our contributors
bra, where acute therapies are targeted. Currently, illustrate the role of MRI in drug development and
PWI is dependent on contrast injection, but arterial selection of acute therapies. Recent studies
spin labelling may well supersede this technique. provide insights into the use of MRI in individual-
These new MRI methods also permit topographic ization of the time window, providing a ‘tissue
analysis of acute infarcts and some insights into clock’ for therapeutic interventions such as
stroke pathophysiology and prognosis. Concurrent thrombolysis. Currently, MR-based studies are
MRA allows analysis of acute arterial occlusion and testing the hypothesis that perfusion–diffusion
monitors recanalization. Magnetic resonance spec- mismatch, the postulated MR signature of the
troscopy provides insights into metabolically ischemic penumbra, can suggest the benefit of
deranged cerebral tissues and provides information thrombolysis beyond the clinically established 3-
that is complementary to DWI and PWI. These new hour time window. Finally, functional brain
techniques are transforming the diagnosis and imaging using brain activation studies and MRI
management of acute stroke. We believe that CT is are leading to a better understanding of brain pro-
likely to be widely replaced by these new MR tech- cessing and brain recovery after stroke.
niques within the next few years. This has already In this book, we have targeted neurologists, other
occurred in many expert stroke centres. stroke physicians, neuroradiologists and other clin-
In this book we have aimed to provide a com- icians involved in stroke diagnosis, imaging and
prehensive and up-to-date summary of the dra- management. We have aimed to encapsulate the
matic developments that have occurred in this development, current and emerging clinical role of
field in the last few years and have also tried to MRI in stroke. We are grateful for the contributions
predict likely advances. The scope of the text of our chapter authors, all leaders in the field of
includes background on the importance of MRI and stroke. A few years ago, experts debated
precise stroke diagnosis, the current uses of CT whether MRI, in acute stroke diagnosis, was ready
including perfusion imaging and an introduction for ‘prime time’. After reading this book, we suspect
to standard and echoplanar MRI techniques. you will agree that it is.
Recent advances in MRI permit exclusion of
intracerebral hemorrhage and this is currently Stephen Davis, Marc Fisher and Steven Warach, 2002

Cambridge Books Online © Cambridge University Press, 2009

 1
The importance of specific diagnosis in stroke patient
management

John N. Fink1 and Louis R. Caplan2

1
Department of Neurology, Christchurch School of Medicine, New Zealand
2
Department of Neurology Beth Israel Deaconess Medical Center, Boston, MA, USA

Introduction: A stroke is not a ‘stroke’ cians should manage patients according to

methods that have been tested by well-designed
Stroke cannot be considered a diagnosis in itself. randomized controlled trials. Unfortunately, few
Stroke refers to any damage to the brain or spinal therapies for patients with stroke have been tested
cord caused by a vascular abnormality, the term gen- with randomized trials, and even fewer have been
erally being reserved for when symptoms begin thoroughly investigated for patients with specific
abruptly. Stroke is anything but a homogeneous stroke subtypes.
entity, encompassing disorders as different as Randomized trials have limitations, including the
rupture of a large blood vessel that causes flooding issue of numbers v. specificity, or ‘lumping’ v. ‘split-
of the subarachnoid space with blood, the occlusion ting’. To provide statistically valid results, random-
of a tiny artery supplying a small but strategic brain ized trials must contain large numbers of patients
site and thrombosis of a venous conduit obstructing with enough end points to analyse within a rela-
outflow of blood from the brain. Each stroke subtype tively short period; therefore ‘lumping’ must pre-
carries with it different implications for acute treat- dominate over ‘splitting’. But, if the results are to be
ment, prognosis and secondary prevention. Each useful for clinical practice, the data must be specifi-
stroke patient has additional variables that influence cally applicable to individual patients. Too often,
management, including the time from onset to pres- there are significant obstacles to doing this.
entation, the severity of the lesion, and associated Investigators have continued to design trials as if
comorbidities as well as social and psychological they expect a single treatment to be effective for all
factors. The availability of non-invasive imaging ischemic stroke patients, resulting in inevitable dis-
techniques has revolutionized the diagnostic appointment. Even when treatments have been
process, enabling a much greater understanding of found effective, there is still a great deal of room for
the relevant pathophysiological processes active in improvement. For example, aspirin has been
the individual patient. This chapter provides an proven to be effective for early secondary preven-
overview of how the specific diagnostic information tion of ‘stroke’ generally, but only prevents 25% of
available from non-invasive investigations can be recurrent strokes within 14 days.1,2 Cost contain-
applied to the management of individual patients. ment and the need to involve a large number of
centres with varying expertise and resources in
trials results in a minimum of patient investigation.
‘Lumping’ vs. ‘splitting’ As a result, accurate subgroup comparisons in trials
become impossible, even when these are reported
The goal of every clinician is to provide the best in a post hoc analysis. Patients who are too ill, old,
care for his or her patients. Where possible, physi- young, or of child-bearing age are often excluded

Cambridge Books Online © Cambridge University Press, 2009

2 John N. Fink and Louis R. Caplan

from trials. Those unable to give informed consent Table 1.1. Stroke classification
or who have too complex, or multiple, illnesses are
also frequently left out. The type of patients that are (a) Clinical stroke classification systems
excluded from these trials are those that doctors are ‘Traditional’
Transient ischemic attack (TIA)
called on to care for every day.
Minor stroke
The term ‘evidence-based’ must be used cau-
Reversible ischemic neurologic deficit (RIND)
tiously when applied to a particular circumstance if
Stroke in progress
that circumstance has not been specifically studied. Completed stroke
Information from trials must be weighed according (a) Oxfordshire Community Stroke Project6
to the context of specific treatment decisions for Total anterior cerebral infarction syndrome (TACI)
individual patients. George Thibault said it well:3 Partial anterior cerebral infarction syndrome (PACI)
Lacunar infarction syndrome (LACI)
We then need to decide which approach in our large thera-
Posterior cerebral infarction syndrome (POCI)
peutic armamentarium will be most appropriate in a particu-
(b) Etiologic classification systems
lar patient, with a particular stage of diseases and particular
TOAST7
coexisting conditions, and at a particular age. Even when ran-
Large artery
domized clinical trials have been performed (which is true
Cardioembolism
for only a small minority of clinical problems), they will often
Small vessel
not answer this question specifically for the patient sitting in
Other determined etiology
front of us in the office or lying in the hospital bed.
Undetermined etiology
The complexity of managing stroke patients is (a) Baltimore-Washington8
increasing. Improvements in diagnostic accuracy Atherosclerotic vasculopathy
have raised new questions about the correct appli- Non-atherosclerotic vasculopathy
cation of existing treatments. There have been Vasculopathy of uncertain cause (lacunar infarct)
Cardiac/transcardiac embolism
many new developments in stroke therapeutics,
Hematological/other
including intravenous and intra-arterial thromboly-
Migrainous stroke
sis, catheter-based interventions such as angio-
Oral contraceptive or exogenous estrogen use
plasty and stenting for both extracranial and Other drug related
intracranial stenoses, the development of new anti- Indeterminate
platelet agents with potentially complimentary
mechanisms of action, and hypothermic treatment,
to name a few. The exact place for all of these thera- and how we diagnose stroke. Early stroke classifica-
pies is not established, yet it is extremely likely that tions relied on clinical information. Terms such as
many of the new treatments that are currently ‘transient ischemic attack (TIA)’, ‘minor stroke’,
‘unproven’ will be able to deliver improved out- ‘reversible ischemic neurologic deficit (RIND)’,
comes for carefully selected patients. Ignoring ‘stroke in progress’ and ‘completed stroke’ were
these new diagnostic and therapeutic develop- used to distinguish stroke subtypes.4 These simplis-
ments is not an option, although a conservative tic distinctions now have little clinical usefulness.
approach must be taken when potentially hazard- Even the term ‘TIA’ is becoming obsolete as smaller
ous therapies have not been rigorously tested. A infarctions have become detectable with magnetic
specific diagnosis is required to optimize treatment resonance imaging (MRI).5
selection. Subsequent classifications have increasingly
focused on stroke etiology, because of its impor-
tance in determining treatment strategies for sec-
Advances in imaging and stroke diagnosis ondary prevention of stroke (Table 1.1). This has
required an increasing emphasis on the results of
Advances in imaging have led to dramatic changes imaging investigations, rather than clinical features.
in our understanding of stroke pathophysiology The authors of the Trial of Org 10172 in Acute

Cambridge Books Online © Cambridge University Press, 2009

Other documents randomly have
different content
 Agriculture - Concept Map
Summer 2024 - Division

Prepared by: Researcher Williams

Date: July 28, 2025

Background 1: Historical development and evolution

Learning Objective 1: Ethical considerations and implications
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 1: Diagram/Chart/Graph]
Learning Objective 2: Study tips and learning strategies
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Learning Objective 3: Ethical considerations and implications
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Learning Objective 4: Literature review and discussion
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Learning Objective 5: Problem-solving strategies and techniques
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Learning outcomes and objectives
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Practical applications and examples
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Remember: Key terms and definitions
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 8: Diagram/Chart/Graph]
Definition: Case studies and real-world applications
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Important: Literature review and discussion
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Conclusion 2: Literature review and discussion
Practice Problem 10: Theoretical framework and methodology
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Learning outcomes and objectives
• Case studies and real-world applications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Remember: Comparative analysis and synthesis
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Practice Problem 13: Statistical analysis and interpretation
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 14: Diagram/Chart/Graph]
Example 14: Ethical considerations and implications
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 15: Diagram/Chart/Graph]
Example 15: Historical development and evolution
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 16: Diagram/Chart/Graph]
Practice Problem 16: Assessment criteria and rubrics
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Remember: Key terms and definitions
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Practice Problem 18: Experimental procedures and results
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Comparative analysis and synthesis
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Part 3: Problem-solving strategies and techniques
Practice Problem 20: Study tips and learning strategies
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Key Concept: Theoretical framework and methodology
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Practice Problem 22: Statistical analysis and interpretation
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Research findings and conclusions
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 24: Diagram/Chart/Graph]
Example 24: Statistical analysis and interpretation
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Key Concept: Best practices and recommendations
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 26: Historical development and evolution
• Case studies and real-world applications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Experimental procedures and results
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Current trends and future directions
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 29: Diagram/Chart/Graph]
Remember: Experimental procedures and results
• Case studies and real-world applications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Appendix 4: Research findings and conclusions
Note: Problem-solving strategies and techniques
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 31: Study tips and learning strategies
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Problem-solving strategies and techniques
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 33: Diagram/Chart/Graph]
Remember: Best practices and recommendations
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Fundamental concepts and principles
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Example 35: Assessment criteria and rubrics
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Definition: Critical analysis and evaluation
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Key terms and definitions
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Research findings and conclusions
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Important: Literature review and discussion
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 40: Diagram/Chart/Graph]
Practice 5: Key terms and definitions
Definition: Study tips and learning strategies
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 41: Diagram/Chart/Graph]
Practice Problem 41: Case studies and real-world applications
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Learning outcomes and objectives
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Case studies and real-world applications
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 44: Interdisciplinary approaches
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Literature review and discussion
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 46: Diagram/Chart/Graph]
Definition: Interdisciplinary approaches
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Key Concept: Best practices and recommendations
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Historical development and evolution
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Problem-solving strategies and techniques
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
References 6: Literature review and discussion
Example 50: Assessment criteria and rubrics
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Key Concept: Problem-solving strategies and techniques
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Key terms and definitions
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Practical applications and examples
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 54: Diagram/Chart/Graph]
Example 54: Experimental procedures and results
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 55: Diagram/Chart/Graph]
Definition: Interdisciplinary approaches
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Key Concept: Ethical considerations and implications
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Research findings and conclusions
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Research findings and conclusions
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Statistical analysis and interpretation
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Introduction 7: Practical applications and examples
Important: Theoretical framework and methodology
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 61: Fundamental concepts and principles
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Comparative analysis and synthesis
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 63: Ethical considerations and implications
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Case studies and real-world applications
• Ethical considerations and implications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Remember: Current trends and future directions
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Definition: Case studies and real-world applications
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Ethical considerations and implications
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
[Figure 68: Diagram/Chart/Graph]
Remember: Theoretical framework and methodology
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Example 69: Learning outcomes and objectives
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Background 8: Interdisciplinary approaches
Example 70: Best practices and recommendations
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 71: Diagram/Chart/Graph]
Key Concept: Key terms and definitions
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Experimental procedures and results
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Practical applications and examples
• Case studies and real-world applications
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 74: Case studies and real-world applications
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Fundamental concepts and principles
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Interdisciplinary approaches
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 77: Diagram/Chart/Graph]
Definition: Study tips and learning strategies
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Definition: Critical analysis and evaluation
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Note: Case studies and real-world applications
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 80: Diagram/Chart/Graph]
Abstract 9: Theoretical framework and methodology
Practice Problem 80: Research findings and conclusions
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Problem-solving strategies and techniques
• Key terms and definitions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Key Concept: Theoretical framework and methodology
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Remember: Practical applications and examples
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Interdisciplinary approaches
• Research findings and conclusions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Interdisciplinary approaches
• Historical development and evolution
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Note: Statistical analysis and interpretation
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Example 87: Problem-solving strategies and techniques
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Practical applications and examples
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Practical applications and examples
• Fundamental concepts and principles
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Test 10: Case studies and real-world applications
Remember: Study tips and learning strategies
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Assessment criteria and rubrics
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Problem-solving strategies and techniques
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 93: Diagram/Chart/Graph]
Practice Problem 93: Best practices and recommendations
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Note: Learning outcomes and objectives
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Important: Assessment criteria and rubrics
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Example 96: Fundamental concepts and principles
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Assessment criteria and rubrics
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Theoretical framework and methodology
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Note: Key terms and definitions
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Exercise 11: Study tips and learning strategies
Remember: Best practices and recommendations
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Experimental procedures and results
• Learning outcomes and objectives
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Critical analysis and evaluation
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Remember: Current trends and future directions
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Definition: Practical applications and examples
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 105: Diagram/Chart/Graph]
Note: Statistical analysis and interpretation
• Best practices and recommendations
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 106: Best practices and recommendations
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 107: Diagram/Chart/Graph]
Practice Problem 107: Assessment criteria and rubrics
• Statistical analysis and interpretation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Definition: Research findings and conclusions
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Critical analysis and evaluation
• Comparative analysis and synthesis
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Exercise 12: Critical analysis and evaluation
Note: Practical applications and examples
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Current trends and future directions
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Key Concept: Fundamental concepts and principles
• Assessment criteria and rubrics
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Definition: Research findings and conclusions
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Definition: Study tips and learning strategies
• Problem-solving strategies and techniques
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Remember: Practical applications and examples
• Interdisciplinary approaches
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Definition: Study tips and learning strategies
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
Formula: [Mathematical expression or equation]
Important: Interdisciplinary approaches
• Literature review and discussion
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Note: Key terms and definitions
• Study tips and learning strategies
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 119: Diagram/Chart/Graph]
Definition: Problem-solving strategies and techniques
• Practical applications and examples
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
Exercise 13: Historical development and evolution
Definition: Literature review and discussion
• Theoretical framework and methodology
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Practice Problem 121: Current trends and future directions
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Formula: [Mathematical expression or equation]
[Figure 122: Diagram/Chart/Graph]
Definition: Case studies and real-world applications
• Current trends and future directions
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Important: Research findings and conclusions
• Experimental procedures and results
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
Key Concept: Key terms and definitions
• Critical analysis and evaluation
- Sub-point: Additional details and explanations
- Example: Practical application scenario
- Note: Important consideration
[Figure 125: Diagram/Chart/Graph]
Welcome to our website – the ideal destination for book lovers and
knowledge seekers. With a mission to inspire endlessly, we offer a
vast collection of books, ranging from classic literary works to
specialized publications, self-development books, and children's
literature. Each book is a new journey of discovery, expanding
knowledge and enriching the soul of the reade

Our website is not just a platform for buying books, but a bridge
connecting readers to the timeless values of culture and wisdom. With
an elegant, user-friendly interface and an intelligent search system,
we are committed to providing a quick and convenient shopping
experience. Additionally, our special promotions and home delivery
services ensure that you save time and fully enjoy the joy of reading.

Let us accompany you on the journey of exploring knowledge and

personal growth!

ebookfinal.com