title: [Primary emergencies: management of acute ischemic stroke].
abstract: The emergency diagnostic strategy for acute ischemic stroke consists of:--identification of stroke, based on clinical examination (sudden onset of a focal neurological deficit);--identification of the ischemic or hemorrhagic nature by MRI or CT;--determination of the early time-course (clinical examination) and the cause. In all strokes (ischemic or hemorrhagic), treatment consists of:--the same general management (treatment of a life-threatening emergency, ensuring normal biological parameters except for blood pressure, and prevention of complications);--decompressive surgery in the rare cases of intracranial hypertension. For proven ischemic stroke, other therapies consist of: rt-PA for patients admitted with 4.5 hours of stroke onset who have no contraindications, and aspirin (160 to 300 mg) for patients who are not eligible for rt-PA. These treatments should be administered within a few hours. A centralized emergency call system (phone number 15 in France) is the most effective way of achieving this objective.
authors.affiliation: Neurologie et pathologie neurovasculaire, Hopital Roger Salengro, CHRU-Lille, et SAMU 59, Rue Emile Laine - 59037 Lille, didier.leys@chru-lille.fr
authors.forename: Didier
authors.initials: D
authors.lastname: Leys
authors.forename: Patrick
authors.initials: P
authors.lastname: Goldstein
mesh_terms: D000208:Acute Disease; D002545:Brain Ischemia / Q000175:diagnosis / Q000628:therapy*; D003266:Continuity of Patient Care / Q000458:organization & administration; D004630:Emergencies; D004632:Emergency Medical Services / Q000379:methods / Q000458:organization & administration; D004638:Emergency Treatment / Q000379:methods; D006801:Humans; D011320:Primary Health Care / Q000379:methods* / Q000458:organization & administration; D020521:Stroke / Q000175:diagnosis / Q000628:therapy*