Author Response: Factors Associated With Fast Early Infarct Growth in Patients With Acute Ischemic Stroke With a Large Vessel Occlusion

We thank Pensato et al. for their comment on our article.1 Our aim was to determine an optimal tool to identify patients who are both at high risk of fast infarct progression and are candidates for future neuroprotection trials.1 We agree that data are lacking in humans regarding the evolution of CBF-based core over time, unlike the well-described diffusion-weighted imaging lesion growth.2 However, we do not believe there is adequate evidence to support the readers' hypothesis that CBF-based core measurements are stable over time. In a small unpublished data set of patients with 2 CT perfusion imaging tests performed 3 hours apart, revealing stable large vessel occlusion, we frequently documented substantial CBF-based core growth. Larger clinical studies would provide more reliable data.