title: Modern medical management of acute ischemic stroke.
abstract: The modern management of patients with ischemic stroke begins by having a system in place that organizes the provision of preventive, acute treatment, and rehabilitative services. In the acute setting, initial evaluation is aimed at rapidly establishing a diagnosis by excluding stroke mimics, distinguishing between ischemic and hemorrhagic strokes, and determining if the patient is a candidate for treatment with intravenous tissue plasminogen activator (IV-tPA, alteplase). In some centers, select patients who do not qualify for administration of IV-tPA may be considered for endovascular intervention. General measures include the use of platelet antiaggregants, treatment of fever, blood pressure management, and continuation of statins if the patient has already been taking them. Post-acute evaluation and management is aimed at secondary prevention and optimizing recovery, including recognition and treatment of post-stroke depression.
authors.affiliation: Duke University Medical Center and Durham VA Medical Center, Durham, NC.
authors.forename: Larry B
authors.initials: LB
authors.lastname: Goldstein
mesh_terms: D002545:Brain Ischemia / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D019091:Critical Pathways; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007262:Infusions, Intravenous; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors
keywords: blood pressure; complications; depression; fever; ischemic stroke; platelet antiaggregants; reperfusion
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