Critical care management of acute ischemic stroke.
OBJECTIVE
To review and examine the efficacy of recently described medical and surgical interventions after acute ischaemic stroke using data from well conducted, clinical trials and systematic reviews. This review will consider recently published or updated articles.


RESULTS
As therapeutic options evolve, including thrombolysis and anti-platelet therapy, prevention of secondary insults, becomes increasingly important during periods of acute cerebral ischaemia in order to prevent worsening of the neurological injury. As in other acute medical conditions, urgent management of patients with acute ischaemic stroke should begin with the assessment and treatment of the airway, breathing, circulation, temperature, and blood glucose control.


CONCLUSIONS
It is estimated that there will be 8.5 million patients with acute ischaemic stroke in the European Union and the USA over the next decade, and of these, about one and a half million will die within six months of stroke onset. Of those who survive, about one third will depend on other people for help with their activities of daily living. Future treatment strategies are likely to involve agents that re-canalise vessels and minimise further neuronal damage.
Andrews
Peter J D
PJ
Intensive Care Unit, Intensive Care and Pain Management, University of Edinburgh, Western General Hospital, Edinburgh, UK. P.Andrews@ed.ac.uk
D000208:Acute Disease; D001786:Blood Glucose / Q000032:analysis; D002545:Brain Ischemia / Q000150:complications / Q000628:therapy*; D003422:Critical Care; D005334:Fever / Q000628:therapy; D005340:Fibrinogen / Q000037:antagonists & inhibitors; D006801:Humans; D011014:Pneumonia / Q000150:complications / Q000628:therapy; D012121:Respiration, Artificial; D020521:Stroke / Q000209:etiology / Q000628:therapy*; D015912:Thrombolytic Therapy
D001786:Blood Glucose; D005340:Fibrinogen