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Title: Thrombolysis for acute ischaemic stroke : can brain imaging and consent processes before treatment be improved?
Author: Kane, Ingrid
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2008
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The general aim of my research was to work on streamlining and improving a few key areas in the care for patients with stroke, particularly those likely to be candidates for thrombolysis. I focussed on: optimising the imaging method for patient selection; assessing the availability of different imaging methods; and evaluating a range of options for obtaining consent for treatment or research in this setting. In the imaging work I discuss some aspects of the two major imaging modalities available to stroke patients – computerised tomography (CT) and magnetic resonance imaging (MRI) and the evidence available for the treatment of acute stroke with thrombolysis. I then explore the evidence lying behind the use of some of the advanced MR imaging modalities and how they may assist in the selection of patients for thrombolysis. Using a systematic review, I play particular attention to the evidence behind the MR perfusion diffusion mismatch theory and the interaction with thrombolysis. Having analysed the evidence available on ‘mismatch’ and thrombolysis I go on to compare the many techniques available for measuring the perfusion lesion and the problems that arise as a result of this. I move from the more complex details of specific MR techniques to the practicalities of imaging acute stroke patients with MR, dealing with a UK survey on the actual availability of MR scanners. Finally, I deal with patients who meet clinical and imaging criteria for thrombolysis who require consent. This is a stage that can cause huge delays, particularly with an acutely ill patient. The process of consent needs to begin imaging. It is a vital first step in thrombolysis because, without it, patients can not undergo the complex MR imaging techniques that are discussed in earlier chapters of the thesis.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available