Saturday, February 15, 2020

Management of acute ischemic stroke

You really do think that survivors are that fucking stupid? Accepting the absolute stupidity of 'management' rather than CURE OR 100% RECOVERY.  You all need to be keel hauled.  Discuss, care and likely mean nothing to survivors. Do you not even know the only goal in stroke? 100% RECOVERY!

Management of acute ischemic stroke

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.l6983 (Published 13 February 2020) Cite this as: BMJ 2020;368:l6983

  1. Michael S Phipps, assistant professor1 2,  
  2. Carolyn A Cronin, associate professor1
    Author affiliations
  1. Correspondence to: M S Phipps mphipps@som.umaryland.edu

ABSTRACT

Stroke is the leading cause of long term disability in developed countries and one of the top causes of mortality worldwide. The past decade has seen substantial advances in the diagnostic and treatment options available to minimize the impact of acute ischemic stroke. The key first step in stroke care is early identification of patients with stroke and triage to centers capable of delivering the appropriate treatment, as fast as possible. Here, we review the data supporting pre-hospital and emergency stroke care, including use of emergency medical services protocols for identification of patients with stroke, intravenous thrombolysis in acute ischemic stroke including updates to recommended patient eligibility criteria and treatment time windows, and advanced imaging techniques with automated interpretation to identify patients with large areas of brain at risk but without large completed infarcts who are likely to benefit from endovascular thrombectomy in extended time windows from symptom onset. We also review protocols for management of patient physiologic parameters to minimize infarct volumes and recent updates in secondary prevention recommendations including short term use of dual antiplatelet therapy to prevent recurrent stroke in the high risk period immediately after stroke. Finally, we discuss emerging therapies and questions for future research.

No comments:

Post a Comment