Ischemic Stroke: Advances in Diagnosis and Management

Emerg Med Clin North Am. 2017 Nov;35(4):911-930. doi: 10.1016/j.emc.2017.07.007.

Abstract

Acute ischemic stroke carries the risk of morbidity and mortality. Since the advent of intravenous thrombolysis, there have been improvements in stroke care and functional outcomes. Studies of populations once excluded from thrombolysis have begun to elucidate candidates who might benefit and thus should be engaged in the process of shared decision-making. Imaging is evolving to better target the ischemic penumbra salvageable with prompt reperfusion. Availability and use of computed tomography angiography identifies large-vessel occlusions, and new-generation endovascular therapy devices are improving outcomes in these patients. With this progress in stroke treatment, risk stratification tools and shared decision-making are fundamental.

Keywords: Acute ischemic stroke; Alteplase; Thrombectomy; Thrombolysis.

Publication types

  • Review

MeSH terms

  • Brain Ischemia / diagnosis*
  • Brain Ischemia / therapy*
  • Disease Management*
  • Humans
  • Neuroimaging / methods*
  • Thrombolytic Therapy / methods*