[Treatment of acute ischemic stroke].
BACKGROUND
Treatment of acute ischemic stroke changes rapidly. The purpose of this article is to present current therapeutic options.


METHODS
The review is based on relevant literature found through a Medline search and on personal clinical experience.


RESULTS
Acute treatment of ischemic stroke encompasses specific therapy aimed at recanalising the occluded vessel (chemical or mechanical thrombolysis) and treatment aimed at protection from the cellular consequences of ischemia (neuroprotection). Acute treatment also encompasses general stabilisation of a critically ill patient; with focus on blood pressure, cardiovascular function, airways, breathing and metabolic disturbances such as hyperglycemia and hyperthermia. Time is a crucial single factor for treatment effect. A rapid chain of delivery and a well-functioning stroke unit are therefore necessary prerequisites for effective acute stroke treatment.


CONCLUSIONS
Effective treatment of acute ischemic stroke is available and should whenever possible be evidence-based. Treatment based on experience and pathophysiological reasoning should be used when scientific evidence lacks.
Thomassen
Lars
L
Nevrologisk avdeling, Haukeland Universitetssjukehus, 5021 Bergen. ltho@haukeland.no
D000208:Acute Disease; D000925:Anticoagulants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy; D002544:Cerebral Infarction / Q000175:diagnosis / Q000188:drug therapy; D017128:Embolectomy; D006801:Humans; D018810:Magnetic Resonance Angiography; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy; D000071939:Stroke Rehabilitation; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D014882:Water-Electrolyte Balance
D000925:Anticoagulants; D000959:Antihypertensive Agents; D010975:Platelet Aggregation Inhibitors