Management of Acute Ischemic Stroke

被引:647
|
作者
Herpich, Franziska [1 ,2 ]
Rincon, Fred [1 ,2 ]
机构
[1] Thomas Jefferson Univ Hosp, Dept Neurol, Philadelphia, PA 19107 USA
[2] Thomas Jefferson Univ Hosp, Dept Neurol Surg, Philadelphia, PA 19107 USA
关键词
cerebral edema; penumbra; secondary neuronal injury; MIDDLE-CEREBRAL-ARTERY; TISSUE-PLASMINOGEN ACTIVATOR; COOPERATIVE ACUTE STROKE; INDIVIDUAL PATIENT DATA; INTRAVENOUS T-PA; ENDOVASCULAR TREATMENT; RANDOMIZED-TRIAL; PREHOSPITAL THROMBOLYSIS; MECHANICAL THROMBECTOMY; DECOMPRESSIVE SURGERY;
D O I
10.1097/CCM.0000000000004597
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objectives: Concise "synthetic" review of the state of the art of management of acute ischemic stroke. Data Sources: Available literature on PubMed. Study Selection: We selected landmark studies, recent clinical trials, observational studies, and professional guidelines on the management of stroke including the last 10 years. Data Extraction: Eligible studies were identified and results leading to guideline recommendations were summarized. Data Synthesis: Stroke mortality has been declining over the past 6 decades, and as a result, stroke has fallen from the second to the fifth leading cause of death in the United States. This trend may follow recent advances in the management of stroke, which highlight the importance of early recognition and early revascularization. Recent studies have shown that early recognition, emergency interventional treatment of acute ischemic stroke, and treatment in dedicated stroke centers can significantly reduce stroke-related morbidity and mortality. However, stroke remains the second leading cause of death worldwide and the number one cause for acquired long-term disability, resulting in a global annual economic burden. Conclusions: Appropriate treatment of ischemic stroke is essential in the reduction of mortality and morbidity. Management of stroke involves a multidisciplinary approach that starts and extends beyond hospital admission.
引用
收藏
页码:1654 / 1663
页数:10
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