Document Detail


Acute ischemic stroke therapy.
MedLine Citation:
PMID:  20936925     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Data from the European Cooperative Acute Stroke Study (ECASS) III trial demonstrated that tissue plasminogen activator given up to 4.5 h after stroke onset improves outcome and treatment guidelines support its use during this time window. Intra-arterial therapy with tissue plasminogen activator or devices is commonly used at large tertiary centers up to 6–8 h after stroke onset, but conclusive evidence of efficacy remains lacking. During the acute phase after stroke onset, blood pressure elevations should be reduced as should substantial elevations in blood glucose. Statins are recommended in essentially all non-cardioembolic stroke patients. The most important future directions for acute stroke therapy are to extend the therapeutic time window and to increase the proportion of patients treated within the currently documented 4.5-h time window. Imaging-guided selection of appropriate patients will likely be a key factor for extending the therapeutic time window and both diffusion/perfusion MRI and perfusion computed tomography will be useful imaging modalities in this effort.
Authors:
Nils Henninger; Rajat Kumar; Marc Fisher
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Expert review of cardiovascular therapy     Volume:  8     ISSN:  1744-8344     ISO Abbreviation:  Expert Rev Cardiovasc Ther     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-12     Completed Date:  2011-01-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101182328     Medline TA:  Expert Rev Cardiovasc Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  1389-98     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Massachusetts Medical Center, 55 Lake Avenue, North Worcester, MA 01655, USA. nils.henninger@umassmemorial.org
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Animals
Blood Glucose
Blood Pressure
Brain Ischemia / drug therapy*,  physiopathology
Fibrinolytic Agents / administration & dosage*
Humans
Practice Guidelines as Topic
Stroke / drug therapy*,  physiopathology
Time Factors
Tissue Plasminogen Activator / administration & dosage*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Fibrinolytic Agents; EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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