Chapter

Specific treatment of acute ischaemic stroke

Michael G. Hennerici, Rolf Kern, Kristina Szabo and Johannes Binder

in Stroke

Published on behalf of Oxford University Press

Published in print July 2012 | ISBN: 9780199582808
Published online July 2012 | e-ISBN: 9780191739651 | DOI: http://dx.doi.org/10.1093/med/9780199582808.003.011

Series: Oxford Neurology Library

Specific treatment of acute        ischaemic stroke

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• Intravenous administration of alteplase within 3hr to onset has been the only approved specific medical therapy for the treatment of patients with acute ischaemic stroke. Recent data suggesting a benefit of therapy up to 4.5hr resulted in approval of this time window. However earlier treatment (<90min) is more likely to result in a favourable outcome. • In carefully selected patients interventional approaches might be an option for treatment in a stroke centre with experienced specialists. • In patients with BA occlusion, treatment should be initiated as soon as possible. In many stroke unit settings this means starting iv thrombolysis and considering additonal ia thrombolysis. • In patients <60yrs with malignant MCA stroke early hemicraniectomy reduces mortality and might improve long-term outcome.

Chapter.  3385 words.  Illustrated.

Subjects: Neurology

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