Journal ArticleDOI
Management of acute ischemic stroke
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TLDR
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, and recent updates in secondary prevention recommendations are reviewed.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.read more
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Journal ArticleDOI
Thrombus Composition and Efficacy of Thrombolysis and Thrombectomy in Acute Ischemic Stroke.
TL;DR: The impact of thrombus composition on the efficacy of mechanical thrombectomy and thrombolysis in patients with acute ischemic stroke is discussed in this paper.
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Annexin A1 protects against cerebral ischemia-reperfusion injury by modulating microglia/macrophage polarization via FPR2/ALX-dependent AMPK-mTOR pathway.
Xin Xu,Weiwei Gao,Lei Li,Jiheng Hao,Bin Yang,Tao Wang,Long Li,Xuesong Bai,Fanjian Li,Honglei Ren,Meng Zhang,Liyong Zhang,Jiyue Wang,Dong Wang,Jianning Zhang,Liqun Jiao +15 more
TL;DR: In this paper, the role of Ac2-26, a pharmacophore N-terminal peptide of ANXA1, in regulating the I/R-induced microglia/macrophage activation and polarization was investigated.
Journal ArticleDOI
Correction to: Clinical Selection Strategies to Identify Ischemic Stroke Patients With Large Anterior Vessel Occlusion: Results From SITS-ISTR (Safe Implementation of Thrombolysis in Stroke International Stroke Thrombolysis Registry)
TL;DR: Clinical Selection Strategies to Identify Ischemic Stroke Patients With Large Anterior Vessel Occlusion: Results From SITS-ISTR (Safe Implementation of Thrombolysis in Stroke International Stroke ThromBolysis Registry),” which published online ahead of print January 13, 2017, and appears in the January 14, 2017 issue of Stroke.
Journal ArticleDOI
Minocycline Promotes Functional Recovery in Ischemic Stroke by Modulating Microglia Polarization Through STAT1/STAT6 Pathways
TL;DR: In this article, a 14-day treatment with minocycline increased the survival rate and promoted functional outcomes evaluated with neurobehavioral evaluation, rotarod test, and corner turning test.
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Neurological Complications of COVID-19: Underlying Mechanisms and Management.
Ghaydaa A. Shehata,Kevin C. Lord,Michaela C. Grudzinski,Mohamed Elsayed,Ramy Abdelnaby,Hatem A. Elshabrawy +5 more
TL;DR: In this paper, the authors discuss the prevalence, pathogenesis, and mechanisms of these neurological sequelae that are secondary to SARS-CoV-2 infection and aim to update neurologists and healthcare workers on the possible neurological complications associated with COVID-19 and the management of these disease conditions.
References
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Journal ArticleDOI
Thrombolysis with Alteplase 3 to 4.5 Hours After Acute Ischemic Stroke
Werner Hacke,Markku Kaste,Erich Bluhmki,Miroslav Brozman,Antoni Dávalos,Donata Guidetti,Vincent Larrue,Kennedy R. Lees,Zakaria Medeghri,Thomas Machnig,Dietmar Schneider,Rüdiger von Kummer,Nils Wahlgren,Danilo Toni +13 more
TL;DR: As compared with placebo, intravenous alteplase administered between 3 and 4.5 hours after the onset of symptoms significantly improved clinical outcomes in patients with acute ischemic stroke; altePlase was more frequently associated with symptomatic intracranial hemorrhage.
Journal ArticleDOI
A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke
Debbie Beumer,Debbie Beumer,Julie Staals,Jeannette Hofmeijer,Jelis Boiten,J. De Vries,Omid S. Eshghi,Koos Keizer,R. van den Berg,A. van der Lugt,Abstr Act +10 more
TL;DR: In patients with acute ischemic stroke caused by a proximal intracranial occlusion of the anterior circulation, intraarterial treatment administered within 6 hours after stroke onset was effective and safe.
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