The term stroke refers to damage of the brain parenchyma which can be secondary to occlusion of a blood vessel causing ischemia (ischemic stroke) or to extravasation of blood outside the confines of the vascular system (hemorrhagic stroke). Patients presenting with acute ischemic stroke may require a variety of medical or interventional management strategies, including mechanical clot retrieval, carotid endarterectomy, carotid stenting, bypass, or decompressive craniotomy. Patients presenting with hemorrhagic stroke secondary to a ruptured vascular lesion may require more extensive management of both the hemorrhage and the lesion. In this chapter, we summarize the most common clinical presentations of patients with ischemic and hemorrhagic strokes and briefly describe modern therapeutic modalities for the most common pathologies.
Ischemic Hemorrhagic Stroke Management Surgery Endovascular
This is a preview of subscription content, log in to check access.
Suggested Readings and References
Saver JL, et al. Time to treatment with endovascular thrombectomy and outcomes from ischemic stroke: a meta-analysis. JAMA. 2016;316(12):1279–88.CrossRefGoogle Scholar
Brott TG, et al. Long-term results of stenting versus endarterectomy for carotid-artery stenosis. N Engl J Med. 2016;374(11):1021–31.CrossRefGoogle Scholar
Rodriguez-Hernandez A, et al. Bypass for the prevention of ischemic stroke. World Neurosurg. 2011;76(6 Suppl):S72–9.CrossRefGoogle Scholar
Schaller B. Extracranial-intracranial bypass to reduce the risk of ischemic stroke in intracranial aneurysms of the anterior cerebral circulation: a systematic review. J Stroke Cerebrovasc Dis. 2008;17(5):287–98.CrossRefGoogle Scholar
Gregson BA, et al. Individual patient data subgroup meta-analysis of surgery for spontaneous supratentorial intracerebral hemorrhage. Stroke. 2012;43(6):1496–504.CrossRefGoogle Scholar
Dobkin BH. Motor rehabilitation after stroke, traumatic brain, and spinal cord injury: common denominators within recent clinical trials. Curr Opin Neurol. 2009;22(6):563–9.CrossRefGoogle Scholar
Mendelow AD, et al. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomised trial. Lancet. 2005;365(9457):387–97.CrossRefGoogle Scholar
Spetzler RF, Martin NA. A proposed grading system for arteriovenous malformations. J Neurosurg. 1986;65(4):476–83.CrossRefGoogle Scholar
Schaller C, Pavlidis C, Schramm J. [Differential therapy of cerebral arteriovenous malformations. An analysis with reference to personal microsurgery experiences]. Nervenarzt. 1996;67(10):860–9.Google Scholar
Stapf C, et al. Predictors of hemorrhage in patients with untreated brain arteriovenous malformation. Neurology. 2006;66(9):1350–5.CrossRefGoogle Scholar
Sandalcioglu IE, et al. Surgical removal of brain stem cavernous malformations: surgical indications, technical considerations, and results. J Neurol Neurosurg Psychiatry. 2002;72(3):351–5.CrossRefGoogle Scholar