Recommendations for comprehensive stroke centers: a consensus statement from the Brain Attack Coalition.
Mark J. Alberts,Richard E. Latchaw,Warren R. Selman,Timothy J. Shephard,Mark N. Hadley,Lawrence M. Brass,Walter J. Koroshetz,John R. Marler,John Booss,Richard D. Zorowitz,Janet B. Croft,Ellen Magnis,Diane Mulligan,Andy Jagoda,Robert E. O'Connor,C. Michael Cawley,John J. Connors,Jean A. Rose-DeRenzy,Marian Emr,Margo Warren,Michael D. Walker +20 more
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A number of key areas supported by evidence-based medicine that are important for a comprehensive stroke center and its ability to deliver the wide variety of specialized care needed by patients with serious cerebrovascular disease are likely to improve outcomes.Abstract:
Background and Purpose—To develop recommendations for the establishment of comprehensive stroke centers capable of delivering the full spectrum of care to seriously ill patients with stroke and cerebrovascular disease. Recommendations were developed by members of the Brain Attack Coalition (BAC), which is a multidisciplinary group of members from major professional organizations involved with the care of patients with stroke and cerebrovascular disease. Summary of Review—A comprehensive literature search was conducted from 1966 through December 2004 using Medline and Pub Med. Articles with information about clinical trials, meta-analyses, care guidelines, scientific guidelines, and other relevant clinical and research reports were examined and graded using established evidence-based medicine approaches for therapeutic and diagnostic modalities. Evidence was also obtained from a questionnaire survey sent to leaders in cerebrovascular disease. Members of BAC reviewed literature related to their field and graded the scientific evidence on the various diagnostic and treatment modalities for stroke. Input was obtained from the organizations represented by BAC. BAC met on several occasions to review each specific recommendation and reach a consensus about its importance in light of other medical, logistical, and financial factors. Conclusions—There are a number of key areas supported by evidence-based medicine that are important for a comprehensive stroke center and its ability to deliver the wide variety of specialized care needed by patients with serious cerebrovascular disease. These areas include: (1) health care personnel with specific expertise in a number of disciplines, including neurosurgery and vascular neurology; (2) advanced neuroimaging capabilities such as MRI and various types of cerebral angiography; (3) surgical and endovascular techniques, including clipping and coiling of intracranial aneurysms, carotid endarterectomy, and intra-arterial thrombolytic therapy; and (4) other specific infrastructure and programmatic elements such as an intensive care unit and a stroke registry. Integration of these elements into a coordinated hospital-based program or system is likely to improve outcomes of patients with strokes and complex cerebrovascular disease who require the services of a comprehensive stroke center. (Stroke. 2005;36:1597-1618.)read more
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Guidelines for the Early Management of Patients With Acute Ischemic Stroke A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
William J. Powers,Alejandro A. Rabinstein,Teri Ackerson,Opeolu Adeoye,Nicholas C. Bambakidis,Kyra J. Becker,José Biller,Michael D. Brown,Bart M. Demaerschalk,Brian L. Hoh,Edward C. Jauch,Chelsea S. Kidwell,Thabele M Leslie-Mazwi,Bruce Ovbiagele,Phillip A. Scott,Kevin N. Sheth,Andrew M. Southerland,Deborah V. Summers,David L. Tirschwell +18 more
TL;DR: These guidelines supersede the prior 2007 guidelines and 2009 updates and support the overarching concept of stroke systems of care and detail aspects of stroke care from patient recognition; emergency medical services activation, transport, and triage; through the initial hours in the emergency department and stroke unit.
Journal ArticleDOI
Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.
William J. Powers,Alejandro A. Rabinstein,Teri Ackerson,Opeolu Adeoye,Nicholas C. Bambakidis,Kyra J. Becker,José Biller,Michael D. Brown,Bart M. Demaerschalk,Brian L. Hoh,Edward C. Jauch,Chelsea S. Kidwell,Thabele M Leslie-Mazwi,Bruce Ovbiagele,Phillip A. Scott,Kevin N. Sheth,Andrew M. Southerland,Deborah V. Summers,David L. Tirschwell +18 more
TL;DR: These guidelines detail prehospital care, urgent and emergency evaluation and treatment with intravenous and intra-arterial therapies, and in-hospital management, including secondary prevention measures that are appropriately instituted within the first 2 weeks.
Journal ArticleDOI
Guidelines for the Management of Spontaneous Intracerebral Hemorrhage. A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
J. Claude Hemphill,Steven M. Greenberg,Craig S. Anderson,Kyra J. Becker,Bernard R. Bendok,Mary Cushman,Gordon L. Fung,Joshua N. Goldstein,R. Loch Macdonald,Pamela H. Mitchell,Phillip A. Scott,Magdy Selim,Daniel Woo +12 more
TL;DR: In this article, the authors present current and comprehensive recommendations for the diagnosis and treatment of acute spontaneous intracerebral hemorrhage, including diagnosis, hemostasis, blood pressure management, inpatient and nursing management, preventing medical comorbidities, surgical treatment, outcome prediction, rehabilitation, prevention of recurrence and future considerations.
Journal ArticleDOI
Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
E. Sander Connolly,Alejandro A. Rabinstein,J. Ricardo Carhuapoma,Colin P. Derdeyn,Jacques E. Dion,Randall T. Higashida,Brian L. Hoh,Catherine J. Kirkness,Andrew M. Naidech,Christopher S. Ogilvy,Aman B. Patel,B. Gregory Thompson,Paul M. Vespa +12 more
TL;DR: Evidence-based guidelines are presented for the care of patients presenting with aneurysmal subarachnoid hemorrhage and offer a framework for goal-directed treatment of the patient with aSAH.
Journal Article
Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology
Harold P. Adams,Gregory J. del Zoppo,Mark J. Alberts,Deepak L. Bhatt,Lawrence F. Brass,Anthony J. Furlan,Robert L. Grubb,Randall T. Higashida,Edward C. Jauch,Chelsea S. Kidwell,Patrick D. Lyden,Lewis B. Morgenstern,Adnan I Qureshi,Robert H. Rosenwasser,Phillip A. Scott,Eelco F. M. Wijdicks +15 more
TL;DR: The goal is to provide an overview of the current evidence about components of the evaluation and treatment of adults with acute ischemic stroke.
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