Diagnosis and Management of Acute Ischemic Stroke

Tasneem F. Hasan, Alejandro Rabinstein, Erik H. Middlebrooks, Neil Haranhalli, Scott L. Silliman, James F Meschia, Rabih G. Tawk

Research output: Contribution to journalReview article

25 Scopus citations

Abstract

Acute ischemic stroke (AIS) is among the leading causes of death and long-term disability. Intravenous tissue plasminogen activator has been the mainstay of acute therapy. Recently, several prospective randomized trials documented the value of endovascular revascularization in selected patients with large-vessel occlusion within the anterior circulation. This finding has led to a paradigm shift in the management of AIS, including wide adoption of noninvasive neuroimaging to assess vessel patency and tissue viability, with the supplemental and independent use of intravenous tissue plasminogen activator to improve clinical outcomes. In this article, we review the landmark studies on management of AIS and the current position on the diagnosis and management of AIS. The review also highlights the importance of early stabilization and prompt initiation of therapeutic interventions before, during, and after the diagnosis of AIS within and outside of the hospital.

Original languageEnglish (US)
Pages (from-to)523-538
Number of pages16
JournalMayo Clinic Proceedings
Volume93
Issue number4
DOIs
StatePublished - Apr 1 2018

ASJC Scopus subject areas

  • Medicine(all)

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    Hasan, T. F., Rabinstein, A., Middlebrooks, E. H., Haranhalli, N., Silliman, S. L., Meschia, J. F., & Tawk, R. G. (2018). Diagnosis and Management of Acute Ischemic Stroke. Mayo Clinic Proceedings, 93(4), 523-538. https://doi.org/10.1016/j.mayocp.2018.02.013