Cerebrovascular disease: Ischemic

Introduction Acute ischemic stroke is a medical emergency. Patients with suspected stroke require urgent evaluation to identify those who may be eligible for time-sensitive reperfusion therapies. Neurohospitalists are uniquely positioned to provide urgent assessment and time-sensitive therapies for patients with cerebrovascular emergencies. This chapter will review the practical aspects of acute stroke evaluation, evidence-based ischemic stroke treatment strategies, and secondary preventative strategies commonly initiated in the hospital. Bedside assessment Stroke is a clinical diagnosis. A focused and systematic approach improves the likelihood of identifying patients with probable ischemic stroke and minimizes the risk of exposing patients with alternate diagnoses to potentially harmful treatment. Although the discussion that follows is presented sequentially, it is important to recognize that many elements of the stroke evaluation occur in parallel, depending on clinical circumstances or availability of resources.