Novel Treatments for Transient Ischemic Attack and Acute Ischemic Stroke - 18/11/20

Doi : 10.1016/j.emc.2020.09.014

Matthew S. Siket, MD, MSc ^a,^b,^⁎ , Rhonda Cadena, MD ^c,^d,^e
^a Division of Emergency Medicine, Department of Surgery, Larner College of Medicine at the University of Vermont, 111 Colchester Avenue, EC2-216, Burlington, VT 05401, USA
^b Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, 111 Colchester Avenue, EC2-216, Burlington, VT 05401, USA
^c Division of Neurocritical Care, Department of Neurology, University of North Carolina, 170 Manning Drive, CB#7025, Chapel Hill, NC 27517, USA
^d Department of Neurosurgery, University of North Carolina, 170 Manning Drive, CB#7025, Chapel Hill, NC 27517, USA
^e Department of Emergency Medicine, University of North Carolina, 170 Manning Drive, CB#7025, Chapel Hill, NC 27517, USA

^∗Corresponding author. Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, 111 Colchester Avenue, EC2-216, Burlington, VT 05401.Department of Neurological SciencesLarner College of Medicine at the University of Vermont111 Colchester AvenueEC2-216BurlingtonVT05401

Résumé

The treatment of acute ischemic stroke is one of the most rapidly evolving areas in medicine. Like all ischemic vascular emergencies, the priority is reperfusion before irreversible infarction. The central nervous system is sensitive to brief periods of hypoperfusion, making stroke a golden hour diagnosis. Although the phrase “time is brain” is relevant today, emerging treatment strategies use more specific markers for consideration of reperfusion than time alone. Innovations in early stroke detection and individualized patient selection for reperfusion therapies have equipped the emergency medicine clinician with more opportunities to help stroke patients and minimize the impact of this disease.

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Keywords : Acute ischemic stroke, Intravenous alteplase, Endovascular thrombectomy