Hyperacute ischemic stroke management: reperfusion and evolving therapies.
Management of acute ischemic stroke patients is organized around several priorities aimed at ensuring optimal patient outcomes, the first of which is reperfusion therapy, followed by determination of pathogenic mechanism by provision of a comprehensive workup to determine probable cause of the ischemic stroke or transient ischemic attack, for the purpose of providing appropriate prophylaxis for subsequent events. Provision of secondary prevention measures along with therapies that prevent complications associated with neurologic disability, and evaluation for the most appropriate level of rehabilitation services are the final priorities during acute hospitalization. This article provides an overview of reperfusion therapies and emerging hemodynamic treatments for hyperacute ischemic strokes. Gaps in the scientific evidence that are driving current blood flow augmentation research are identified.
Alexandrov
Anne W Wojner
AW
Acute & Critical Care, School of Nursing, Comprehensive Stroke Center, University of Alabama, Birmingham 35249, USA. annealex@uab.edu
D000208:Acute Disease; D000465:Algorithms; D002545:Brain Ischemia / Q000150:complications*; D015984:Causality; D015908:Counterpulsation; D003422:Critical Care / Q000379:methods; D004632:Emergency Medical Services / Q000379:methods; D016529:Emergency Nursing / Q000379:methods; D004638:Emergency Treatment / Q000379:methods; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005440:Fluid Therapy; D006801:Humans; D017410:Practice Guidelines as Topic; D015424:Reperfusion / Q000379:methods* / Q000451:nursing / Q000639:trends; D055502:Secondary Prevention / Q000379:methods; D020521:Stroke / Q000145:classification / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator