Neurocritical care for acute ischemic stroke.
Therapy for acute ischemic stroke includes general and specific measures. General management such as respiratory and cardiac care, fluid and electrolyte management, blood pressure control, and treatment of increased ICP is the basis of all stroke treatment. Specific treatment is directed to recanalization of the occluded vessel, control of life-threatening brain edema, and protection of neuronal tissue against the toxic effects of ischemia. Although controlled studies are still lacking, application of the proposed general interventions provides a high-quality standard in patients with acute stroke. Among specific therapies, medical thrombolysis has demonstrated instances of significant and sustained neurologic improvement. Several multicenter trials are underway to confirm these preliminary results. In addition to thrombolysis, cell-protecting drugs hold promise for the future. Presumably, a combination of thrombolytic and cell-protecting agents will be the treatment of choice in early stroke in the future.
D000208:Acute Disease; D000328:Adult; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D001921:Brain / Q000503:physiopathology* / Q000601:surgery; D002545:Brain Ischemia / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D002533:Cerebral Angiography; D004632:Emergency Medical Services; D007839:Functional Laterality; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008297:Male; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed