While the effectiveness of intravenous thrombolysis (IVT) decreases over time, patients show considerable variability in how quickly their ischemic core progresses. Quantitative net water uptake (NWU) has emerged as a biomarker indicating blood-brain barrier disruption and may better reflect the "tissue clock" than time alone. Low NWU is associated with favorable outcomes, whereas high NWU predicts poor outcomes and futile recanalization. The study aims to determine whether NWU measured on initial non-contrast CT is a treatment effect modifier for the IVT therapy.
Acute ischemic stroke treated with intravenous thrombolysis
Imaging with non-contrast cranial CT on admission
Follow-up imaging with non-contrast cranial CT or MRI 12-24 hours after IVT
Final Infarct volume > 5ml
Known use of oral anticoagulation (OAC) on admission
Preexisting ischemic infarction on admission non-contrast cranial CT
Patients with large vessel occlusion AIS who underwent mechanical thrombectomy
Low imaging quality precluding radiological measurements