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Diagnosis and management of acute ischaemic stroke
  1. Robert Hurford1,
  2. Alakendu Sekhar2,
  3. Tom A T Hughes3,
  4. Keith W Muir4
  1. 1Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
  2. 2Department of Neurology, Walton Centre for Neurology and Neurosurgery, Liverpool, UK
  3. 3Department of Neurology, University Hospital of Wales Healthcare NHS Trust, Cardiff, UK
  4. 4Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
  1. Correspondence to Professor Keith W Muir, Institute of Neuroscience and Psychology, University of Glasgow, Glasgow G51 4TF, UK; keith.muir{at}glasgow.ac.uk

Abstract

Acute ischaemic stroke is a major public health priority and will become increasingly relevant to neurologists of the future. The cornerstone of effective stroke care continues to be timely reperfusion treatment. This requires early recognition of symptoms by the public and first responders, triage to an appropriate stroke centre and efficient assessment and investigation by the attending stroke team. The aim of treatment is to achieve recanalisation and reperfusion of the ischaemic penumbra with intravenous thrombolysis and/or endovascular thrombectomy in appropriately selected patients. All patients should be admitted directly to an acute stroke unit for close monitoring for early neurological deterioration and prevention of secondary complications. Prompt investigation of the mechanism of stroke allows patients to start appropriate secondary preventative treatment. Future objectives include improving accessibility to endovascular thrombectomy, using advanced imaging to extend therapeutic windows and developing neuroprotective agents to prevent secondary neuronal damage.

  • STROKE
  • CEREBROVASCULAR DISEASE
  • NEUROANATOMY
  • NEUROEPIDEMIOLOGY
  • NEURORADIOLOGY
  • REHABILITATION
  • DYSPHAGIA

This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the COVID-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/practneurol-2020-002557

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    Footnotes

    • Contributors RH drafted the manuscript. Other authors revised the manuscript.

    • Acknowledgement The authors would like to thank Mr Philip Baker for his assistance in designing the figures.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Commissioned externally reviewed by John Fink, Christchurch, New Zealand and Michael O’Sullivan, Brisbane, Australia.

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