Therapeutic Intervention in Acute Ischemic Stroke: a Paradigm Shift

Abstract

Strokes are classified as ischemic or hemorrhagic. Acute ischemic strokes (AIS) are more common than hemorrhagic and they refer to thrombosis or embolism. They are classified into large artery infarctions, small vessel or lacunar infarctions and cardioembolic infarctions. As timely restoration of blood flow (reperfusion) using thrombolytic therapy or percutaneous intervention is the key and most effective strategy for salvaging ischemic myocardial tissue in acute myocardial infarction, the same principle applies to AIS. There is a narrow therapeutic window during which this can be accomplished, since the benefit of reperfusion continually decreases over time. During the acute phase of ischemia, be it myocardial or cerebral, a rapid determination and triaging of patients who are eligible for reperfusion is key to the success of such a salvaging strategy (... excerpt)