Neuroprotection for Acute Ischemic Stroke
- DOI:
- 10.1093/med/9780190280253.003.0010
Acute ischemic stroke (AIS) is the leading cause of acquired neurological disability worldwide. AIS most commonly occurs when a cerebral artery is occluded, leading to irreversible brain injury and neurologic disability. Acute supportive physiological interventions and close monitoring on a stroke unit are beneficial to optimize overall recovery and functional outcome. Phamacological treatment options are limited though as the only FDA-approved therapy for AIS is the thrombolytic agent intravenous recombinant tissue plasminogen activator (Alteplase, rtPA), which improves functional outcome in therapeutic time windows ranging up to 3–4.5 hours. Several clinical trials assessing the efficacy of endovascular therapy have shown a benefit in carefully selected patients with a documented large vessel occlusion (LVO), and subsequently are becoming part of the standard practice in this AIS subset. Clinical trials using various imaging paradigms to enhance patient selection for thrombolytic therapy, endovascular therapy and neuroprotection therapies are all progressing.
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