Being late may not be too late! Widening the horizons for stroke thrombolysis with Computed Tomographic Perfusion (CTP) and Magnetic Resonance (MR) brain imaging

thrombolytic Abstract Stroke is the leading cause of adult disability worldwide. Most strokes are ischemic in nature and amenable to cure if detected and treated early enough with reperfusion therapy. Delay in presentation and unknown onset time are key limiting factors of reperfusion therapy in current practice. Cerebral perfusion computed tomographic imaging (CTP) and magnetic resonance imaging (MRI) with special sequences aid in identifying acute stroke patients who present late or with unknown onset time, yet reperfusion treatment may have a benefit. Establishing such imaging facilities at tertiary care hospitals in Sri Lanka would strengthen acute stroke care by offering hope for a cure. It is cost-effective in long term by reducing the burden of prolonged disabilities in stroke