Management of ischemic stroke in the hyperacute phase.

Management of ischemic stroke in the hyperacute phase. Panminerva Med. 2013 Mar;55(1):59-78 Authors: Devos D, Sevin M, De Gaalon S, Lintia-Gaultier A, Guillon B Abstract Over the last 15 years, advances in acute ischemic stroke (AIS) management have led to a significant reduction in the morbidity and mortality related to this serious disease. This has resulted from progress in imaging technology, increased access to imaging procedures, enhanced coordination in stroke care from emergency departments to rehabilitation centers, development of organized inpatient stroke units, and to the widespread use of acute thrombolysis. Once the diagnosis of AIS is confirmed by neuroimaging, the etiological work up is conducted in parallel with therapeutic measures by stroke units. The intravenous administration of recombinant tissue plasminogen activator (rt-PA) remains the most beneficial intervention in emergency stroke management, but it must be administered within 4.5 hours following the onset of symptoms and only in eligible patients. Recently, several procedures for increasing the efficacy of arterial recanalization have emerged, including intra-arterial administration of thrombolytic agents, mechanical reopening techniques, development of new thrombolytic agents, protocol modifications that allow treatment beyond 4.5 hours or in individuals >80 years old, and remote patient evaluation via telemedicine. So far, no potentially neuroprotecti...
Source: Panminerva Medica - Category: Journals (General) Tags: Panminerva Med Source Type: research