Inclusion Criteria- Significant ischemic stroke suspicion (NIHSS 1-24) and paresis of an extremity.
- Treatment with rtPa within 4.5 hours from debut of symptoms.
- Age above 18 (changed from 01.01.2010 to no upper age limit)
- Independent in daily living before the acute onset of symptoms. (mrs=2)
- MR scan showing DWI lesion, consistent with acute ischemic stroke.
Exclusion Criteria- Contraindications for iv rtPA
- Onset of symptoms older than 4.5 hours
- Previous diseases of the brain: Intracranial aneurisms or arteriovenous malformations. Brain surgery or hemorrhagic stroke. Former ischemic stroke within the last 3 months.
- Heart diseases: Infectious endocarditis or suspicion of septic emboli, pericarditis, ventricular thrombosis, aneurisms of the heart wall or major heart failure.
- Serious diseases: Cancer, AIDS, dementia, significant abuse, renal failure, liver diseases such as liver failure, cirrhosis, portal hypertension, active hepatitis.
- Major ischemic stroke where the patient is unconscious.(NIHSS > 25).
- Symptoms suspect for migraine, Multiple sclerosis, TIA or another neurological disease than ischemic stroke.
- Contraindications for MRI scans
- Tumor cerebri, cerebral abscesses
- Known hypersensitivity to Gadovist or any of its ingredients, acute or chronic severe renal impairment (GFR < 30 ml/min/1.73m2), acute renal insufficiency of any severity due to the hepato-renal syndrome or in the perioperative liver transplantation period.
- Caution with using Gadovist to patients with severe cardiovascular disease, and only to be used after a risk-benefit assessment.
- Caution with using Gadovist in patients with low threshold for seizures.
- Blood glucose < 2, 8 mmol/l or > 22 mmol/l