With the advent of effective therapy, acute ischemic stroke must now be distinguished as a medical emergency. Ultrarapid assessment and early intervention are essential, since the window of therapeutic opportunity is limited to the first few hours after the onset of symptoms. The emergent treatment of acute ischemic stroke has two major goals: restoration of cerebral blood flow (reperfusion) and limitation of neuronal injury (neuroprotection). At present, only thrombolysis with tissue plasminogen activator (t-PA) within 3 hours has been shown to be beneficial.<sup>66 The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group Tissue plasminogen activator for acute ischemic stroke N Engl J Med 1995 ;  333 : 1581-1587

Cliccare qui per andare alla sezione Riferimenti</sup> Many other strategies are being explored, and the majority of these must also be initiated during the earliest stages of acute ischemic stroke. In this survey, we propose an accelerated approach to the acute ischemic stroke patient and review the completed and ongoing major clinical trials that are changing the course of acute stroke management.