RT Journal Article
SR Electronic
T1 Diagnosis and management of acute ischaemic stroke
JF Practical Neurology
JO Pract Neurol
FD BMJ Publishing Group Ltd
SP 304
OP 316
DO 10.1136/practneurol-2020-002557
VO 20
IS 4
A1 Robert Hurford
A1 Alakendu Sekhar
A1 Tom A T Hughes
A1 Keith W Muir
YR 2020
UL http://pn.bmj.com/content/20/4/304.abstract
AB 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.