[Acute ischemic stroke: time is brain!].
Care of patients with acute ischemic stroke in dedicated stroke units reduces the rates of death and disability independently from any specific treatment. The only validated treatment for acute ischemic stroke is thrombolysis with intravenous alteplase. Its efficacy is strongly time-dependent. It is currently demonstrated for an administration up to 3 hours after symptom onset. Intravenous fibrinolysis for acute ischemic stroke is associated with an increased risk of symptomatic intracerebral haemorrhage. This can be reduced by rigorous application of recommendations for drug prescription. The efficacy of intravenous alteplase is relatively weak in patients with large artery occlusion. Combined therapies, using transcranial ultrasound, intraarterial thrombolysis, or clot retrieval devices are being evaluated to improve the efficacy of thrombolysis.
Larrue
Vincent
V
Service de neurologie vasculaire EA 2049, hôpital Rangueil, CHU de Toulouse, 31059 Toulouse. larrue.v@chu-toulouse.fr
D000208:Acute Disease; D002543:Cerebral Hemorrhage / Q000139:chemically induced; D016001:Confidence Intervals; D004453:Echoencephalography; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007362:Intensive Care Units; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000379:methods; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator