Does your hospital have EXACT PROTOCOLS to treat this type of stroke? Or are they just winging it and hope you'll survive? Better ask now before you need this.
Hemodynamic Stroke: Emerging Concepts, Risk Estimation, and Treatment
Abstract
Ischemic
stroke can arise from the sudden occlusion of a brain-feeding artery by
a clot (embolic), or local thrombosis. Hemodynamic stroke occurs when
blood flow does not sufficiently meet the metabolic demand of a brain
region at a certain time. This discrepancy between demand and supply can
occur with cerebropetal arterial occlusion or high-grade stenosis but
also arises with systemic conditions reducing blood pressure. Treatment
of hemodynamic stroke is targeted toward increasing blood flow to the
affected area by either systemically or locally enhancing perfusion.
Thus, blood pressure is often maintained above normal values, and
extra-intracranial flow augmentation bypass surgery is increasingly
considered. Still, current evidence supporting the superiority of
pressure or flow increase over conservative measures is limited.
However, methods assessing hemodynamic impairment and identifying
patients at risk of hemodynamic stroke are rapidly evolving.
Sophisticated models incorporating clinical and imaging factors have
been suggested to aid patient selection. In this narrative review, we
provide current state-of-the-art knowledge about hemodynamic stroke,
tools for assessment, and treatment options.
Graphical Abstract
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