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Lim et al. Vessel Plus 2021;5:34 https://dx.doi.org/10.20517/2574-1209.2021.44 Page 7 of 9

Can infarct and penumbral location aid clinical decision?
Up till now, the concept of the ischemic penumbra has been discussed in terms of mismatch volume and
without information on location [11,50] . Such information can help to reveal why some patients with large
ischemic core have recovery of motor function. This latter observation of good outcome despite having a
large core requires an understanding of the topography of the penumbra and the function of the infarcted
regions. Analysis taking into account information on neuroanatomical location of penumbra and infarct
requires complex multivariate analysis and is not yet available for clinical use.

CONCLUSION
Much progress has been made in the evaluation of acute stroke patients with advanced imaging.
Randomized trial evidence now exists that demonstrates positive functional outcome when patient selection
is based on advanced imaging, challenging the previous paradigm of time-based stroke therapies. The recent
success of this tissue-based approach is set to influence current stroke management and the future direction
of stroke research.

DECLARATIONS
Authors’ contributions
Involved in the conception, literature review, editing and final approval: Lim A, Senanayake C, Clissold B,
Phan T, Ma H
Involved in the drafting of the initial manuscript: Lim A

Availability of data and materials
Not applicable.

Financial support and sponsorship
Lim A is supported by an Australian Government Research Training Program (RTP) Scholarship and is in
receipt of the Monash Health Emerging Researcher Fellowship.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2021.

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