Acute stroke therapies

Stroke is a medical emergency, with a high mortality rate. It is the second leading cause of death worldwide and is the most common cause of serious, long-term disability in adults. That is why its acute management plays most important role in saving a patient’s life and preventing disability.

Immediate goals of Acute Stroke Management

  • Stabilize patient

  • Complete initial evaluation and assessment, including imaging and laboratory studies like:

    • CT angiography

    • CT perfusion studies

    • Magnetic resonance imaging (MRI)

  • Minimizing brain injury

  • Making critical decisions focused on the need for intubation, blood pressure control, and determination of risk/benefit for thrombolytic intervention

  • Treating medical complications

  • Uncovering the pathophysiologic basis of the patient’s symptoms

Current treatments for acute stroke

  • Thrombolytic Therapy (IV) with t-PA and endovascular therapies using stent retriever devices

  • Stabilization of Airway and Breathing via rapid sequence intubation or induction

  • Intravenous Access and Cardiac Monitoring

  • Maintaining blood sugar control with insulin therapy, with the goal of establishing normoglycemia (90-140 mg/dL)

  • Blood Pressure Control as both elevated and low blood pressures are associated with poor outcomes

  • Comorbid medical problems need to be addressed

  • Prophylaxis for complications such as deep vein thrombosis, pulmonary embolism, aspiration pneumonia and other infections are also essential