[Diagnosis and management for acute ischemic stroke].
The management for acute stroke has been changed greatly in Japan. Because use of intravenous administration of tissue plasminogen activator (IV-t-PA) for acute brain infarction within 3 hours of onset has been approved by Japanese government from October, 2005. Now, if acute stroke patient arrivals at hospital within 3 hours of onset, we consider that such patients should be treated with t-PA therapy. The accurate diagnosis should be made by systematic evaluation using CT/MRI, neurosonology including transcranial Doppler, carotid echography, and echocardiography (TEE and TTE), SPECT, and angiography. In particular, it is important to assess the arteries from heart and brain. The grad A for treatment of acute stroke is recommended as IV-t-PA therapy, aspirin administration within 48 hours of stroke onset, and the management in stroke unit. In particular, stroke unit can improve functional outcome and to reduce the length of hospital stay. The evidence directing therapy for acute stroke is changing rapidly.
Kimura
Kazumi
K
Department of Stroke Medicine, Kawasaki Medical School.
D000203:Activities of Daily Living; D001241:Aspirin / Q000008:administration & dosage; D003952:Diagnostic Imaging; D006801:Humans; D007902:Length of Stay; D008689:Methacrylates / Q000008:administration & dosage; D009460:Neurologic Examination; D010347:Patient Care Planning; D010348:Patient Care Team; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011788:Quality of Life; D020521:Stroke / Q000145:classification / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage
D008689:Methacrylates; D010975:Platelet Aggregation Inhibitors; D010959:Tissue Plasminogen Activator; C034364:ozagrel; D001241:Aspirin