Acute Treatment of Ischemic Stroke

Neurol Clin. 2022 Feb;40(1):17-32. doi: 10.1016/j.ncl.2021.08.002.

Abstract

Ischemic stroke affects 2.5% of the population of the United States and is the leading cause of disability. This article outlines the evidence to support intravenous thrombolysis with alteplase and tenecteplase, thrombolysis in the setting of DWI/flair mismatch, endovascular treatment in the 6-hour and 6- to 24-hour window, and the use of telemedicine in acute stroke. Current controversies and ongoing trials within endovascular treatment are also detailed. Case presentations are included to provide clinical context and the application of data to practice.

Keywords: Acute ischemic stroke; Endovascular treatment; Thrombolysis.

Publication types

  • Review

MeSH terms

  • Brain Ischemia* / complications
  • Brain Ischemia* / drug therapy
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Ischemic Stroke*
  • Stroke* / drug therapy
  • Tenecteplase / therapeutic use
  • Thrombolytic Therapy
  • Tissue Plasminogen Activator / therapeutic use
  • Treatment Outcome
  • United States

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator
  • Tenecteplase