Management of Acute Ischemic Stroke

Ponniah Vanamoorthy; Kavu D. Samy; Prasanna U. Bidkar

doi:10.1055/s-0039-1692831

Journal of Neuroanaesthesiology and Critical Care, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2019; 06(02): 105-118
DOI: 10.1055/s-0039-1692831

Review Article

Indian Society of Neuroanaesthesiology and Critical Care

Management of Acute Ischemic Stroke

Ponniah Vanamoorthy

¹Department of Neuroanaesthesiology and Neurocritical Care, Institute of Neurosciences and Spinal Disorders, MGM Health Care, Chennai, Tamil Nadu, India

,

Kavu D. Samy

¹Department of Neuroanaesthesiology and Neurocritical Care, Institute of Neurosciences and Spinal Disorders, MGM Health Care, Chennai, Tamil Nadu, India

,

Prasanna U. Bidkar

²Division of Neuroanaesthesiology, Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India

› Institutsangaben

Abstract

Acute ischemic stroke (AIS) is a time-sensitive neurological emergency and it remains to be the most common type of stroke. Rapid neuroimaging is the cornerstone for initiating time-sensitive interventions in the treatment of AIS. Revascularization therapies that were once considered irreversible, including intravenous thrombolysis (IVT) and endovascular treatment (EVT), administered in a timely fashion have revolutionized the treatment of AIS. The indications for these therapies have expanded over the past few years and a lot of advancements are happening every year. IVT is offered to all eligible patients presenting within 3 hours of symptom onset and up to 4.5 hours with additional criteria. EVT with stent retrievers or aspiration devices, once limited to the first 6 hours of stroke onset, is now being offered up to 24 hours with advanced image-guided patient selection, which includes a computed tomography or magnetic resonance perfusion imaging. A protocol-based approach to the management of stroke, beginning from prehospital care reduces the time delay in the initiation of treatment. Providing access to these therapies by creating systems of care, hospital stroke team, and “stroke codes” improves the outcome of patients with AIS.

Keywords

stroke - acute ischemic stroke - intravenous thrombolysis - telestroke - CT perfusion

Volltext

Referenzen

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