TY - JOUR
T1 - Diagnosis and Management of Acute Ischemic Stroke
AU - Hasan, Tasneem F.
AU - Rabinstein, Alejandro A.
AU - Middlebrooks, Erik H.
AU - Haranhalli, Neil
AU - Silliman, Scott L.
AU - Meschia, James F.
AU - Tawk, Rabih G.
N1 - Publisher Copyright:
© 2018 Mayo Foundation for Medical Education and Research
PY - 2018/4
Y1 - 2018/4
N2 - 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.
AB - 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.
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U2 - 10.1016/j.mayocp.2018.02.013
DO - 10.1016/j.mayocp.2018.02.013
M3 - Review article
C2 - 29622098
AN - SCOPUS:85044162065
SN - 0025-6196
VL - 93
SP - 523
EP - 538
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 4
ER -