title: [State-of-the-art Treatment of Acute Stroke].
abstract: This article gives an overview about diagnostic imaging and treatment options of acute patients with ischemic and hemorrhagic stroke with emphasis on evidence from relevant studies published in the last 2 years. A computed tomography of the brain with CT-angiography should be the minimal standard imaging modality in acute ischemic stroke patients. Diffusion-weighted/imaging-fluid-attenuated inversion recovery (FLAIR)-mismatch magnetic resonance imaging can be useful in patients with wake-up stroke to select patients for recanalisation therapies. Systemic thrombolysis with rt-PA within 4.5 hours after symptom onset and mechanical thrombectomy with stent retrievers within 6 hours and proven occlusion of a large vessel in the anterior brain circulation are both evidence-based treatments. In contrast, there are no major therapeutic advances in patients with hemorrhagic stroke. The systolic blood pressure should be lowered < 140  mm Hg in these patients within one hour. Both acute ischemic and hemorrhagic stroke and patients with a transient ischemic attack should be monitored and treated on a stroke unit due to an improved outcome. A prophylactic antibiotic treatment and very early mobilization during the first 24 hours is not recommended in acute stroke patients.
authors.affiliation: Klinik für Neurologie, Alfried Krupp Krankenhaus Essen-Rüttenscheid, Essen.
authors.forename: R
authors.initials: R
authors.lastname: Weber
authors.affiliation: Klinik für Radiologie und Neuroradiologie, Alfried Krupp Krankenhaus Essen-Rüttenscheid, Essen.
authors.forename: H
authors.initials: H
authors.lastname: Nordmeyer
mesh_terms: D002545:Brain Ischemia / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D019635:Neurosurgical Procedures; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D015912:Thrombolytic Therapy