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Management of acute stroke within the stroke pathway and stroke clinics 

Management of acute stroke within the stroke pathway and stroke clinics
Management of acute stroke within the stroke pathway and stroke clinics

Jonathan Birns

and Ajay Bhalla



Large, space-occupying hemispheric ischaemic brain infarcts are associated with the development of massive brain oedema, which may lead to herniation and early death without decompressive hemicraniectomy to increase the chances of survival and improved functional outcome.

Updated on 27 August 2020. The previous version of this content can be found here.
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date: 01 July 2022

There have been considerable advances in stroke research leading to translation of drug therapy for stroke into the clinical arena. Thrombolysis for ischaemic stroke is a key advance that significantly reduces disability. This has revolutionized the manner in which acute stroke is treated as a medical emergency. The use of advanced imaging techniques and adjuncts to thrombolysis could potentially improve selection of patients who may benefit from reperfusion therapy such as mechanical thrombectomy and allow treatment decisions to be based on individual brain pathophysiology, rather than arbitrary time windows. It is likely that reconfiguration of stroke services may be required to accommodate further delivery of hyperacute interventions for acute stroke.

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