Overview of Acute Ischemic Stroke Evaluation and Management.
Overview of Acute Ischemic Stroke Evaluation and Management.
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DOI：
10.3390/biomedicines9101486
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发表时间：
2021-10-16
期刊：
影响因子：
4.7
通讯作者：
Kelley RE
中科院分区：
文献类型：
--
作者：
Hasan TF;Hasan H;Kelley RE
中风是全球死亡和残疾的主要原因。在现代治疗之前，急性期卒中后死亡率约为10%，近一半的患者发展为中度至重度残疾。急性卒中管理最基本的方面是“时间就是大脑”。在急性缺血性卒中中，再灌注治疗（包括静脉内重组组织纤溶酶原激活剂（IV TPA）和/或血管内血栓切除术）的主要治疗目标是快速恢复脑血流至有脑梗死风险的可挽救缺血脑组织。发现几项具有里程碑意义的血管内血栓切除术试验在选择的近端前循环闭塞引起的急性卒中患者中获益，这导致了急性缺血性卒中管理的范式转变。在这个急性卒中护理的现代时代，更多的患者将在卒中后不同程度的残疾中存活。全面的卒中康复计划对于优化卒中后结局至关重要。了解中风恢复的自然史，并采用多学科方法，将提高成功康复的机会。在这篇文章中，我们提供了一个概述的评价和当前的进展，在急性缺血性脑卒中的管理，开始在院前设置和急诊科，其次是急性脑卒中后的医院管理和康复。
Stroke is a major contributor to death and disability worldwide. Prior to modern therapy, post-stroke mortality was approximately 10% in the acute period, with nearly one-half of the patients developing moderate-to-severe disability. The most fundamental aspect of acute stroke management is “time is brain”. In acute ischemic stroke, the primary therapeutic goal of reperfusion therapy, including intravenous recombinant tissue plasminogen activator (IV TPA) and/or endovascular thrombectomy, is the rapid restoration of cerebral blood flow to the salvageable ischemic brain tissue at risk for cerebral infarction. Several landmark endovascular thrombectomy trials were found to be of benefit in select patients with acute stroke caused by occlusion of the proximal anterior circulation, which has led to a paradigm shift in the management of acute ischemic strokes. In this modern era of acute stroke care, more patients will survive with varying degrees of disability post-stroke. A comprehensive stroke rehabilitation program is critical to optimize post-stroke outcomes. Understanding the natural history of stroke recovery, and adapting a multidisciplinary approach, will lead to improved chances for successful rehabilitation. In this article, we provide an overview on the evaluation and the current advances in the management of acute ischemic stroke, starting in the prehospital setting and in the emergency department, followed by post-acute stroke hospital management and rehabilitation.
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影响因子：
9.9
作者：
Arsava, E. M.;Ballabio, E.;Ay, H.
通讯作者：
Ay, H.
DOI：
10.1002/14651858.cd006187.pub2
发表时间：
2009-01-21
期刊：
The Cochrane database of systematic reviews
影响因子：
--
作者：
Bernhardt, Julie;Thuy, Matthew Nt;Legg, Lynn A
通讯作者：
Legg, Lynn A
影响因子：
158.5
作者：
Berkhemer, O. A.;Fransen, P. S. S.;Dippel, D. W. J.
通讯作者：
Dippel, D. W. J.
DOI：
10.1056/nejmoa1214300
发表时间：
2013-03-07
期刊：
The New England journal of medicine
影响因子：
--
作者：
Broderick JP;Palesch YY;Demchuk AM;Yeatts SD;Khatri P;Hill MD;Jauch EC;Jovin TG;Yan B;Silver FL;von Kummer R;Molina CA;Demaerschalk BM;Budzik R;Clark WM;Zaidat OO;Malisch TW;Goyal M;Schonewille WJ;Mazighi M;Engelter ST;Anderson C;Spilker J;Carrozzella J;Ryckborst KJ;Janis LS;Martin RH;Foster LD;Tomsick TA;Interventional Management of Stroke (IMS) III Investigators
通讯作者：
Interventional Management of Stroke (IMS) III Investigators
影响因子：
48
作者：
Campbell, Bruce C. V.;Majoie, Charles B. L. M.;Mitchell, Peter J.
通讯作者：
Mitchell, Peter J.