Skip to main content
SpringerLink
Log in

Brief Description of Recent Developments in Diagnosis and Treatment

  • Chapter
  • First Online:
Ischemic Stroke

Part of the book series: Emergency Management in Neurology ((EMN))

  • 3651 Accesses

Abstract

World Health Organization (WHO) defines stroke as the sudden onset of neurological symptoms attributable solely to a brain disorder and caused by a circulatory disorder lasting more than 24 h.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 29.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 37.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mozaffarian D, Benjamin EJ, Go AS et al (2015) Heart disease and stroke statistics—2016 update a report from the American Heart Association. Circulation 132. doi: 10.1161/CIR.0000000000000350.

  2. Adams HP Jr, Davis PH, Leira EC et al (1999) Baseline NIH Stroke Scale score strongly predicts outcome after stroke: a report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST). Neurology 53:126

    Article  CAS  PubMed  Google Scholar 

  3. Bonita R, Beaglehole R (1998) Modification of Rankin Scale: recovery of motor function after stroke. Stroke 19:1497

    Article  Google Scholar 

  4. Wardlaw JM, Mielke O (2005) Early signs of brain infarction at CT: observer reliability and outcome after thrombolytic treatment-systematic review. Radiology 235:444

    Article  PubMed  Google Scholar 

  5. Leys D, Pruvo JP, Godefroy O et al (2001) Prevalence and significance of early ischemic changes on computed tomography in acute stroke. JAMA 286:2830

    Article  Google Scholar 

  6. Patel SC, Levine SR, Tilley BC et al (2001) Lack of clinical significance of early ischaemic changes on computed tomography in acute stroke. JAMA 286:2830

    Article  CAS  PubMed  Google Scholar 

  7. Wardlaw JM, Dorman JP, Lewis SC, Sandercock PA (1999) Can stroke physicians and neuroradiologists identify signs of early cerebral infarction on CT? J Neurol Neurosurg Psychiatry 67:651

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Barber PA, Demchuk AM, Zhang J, Buchan AM (2000) Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECT Study Group Alberta Stroke Programme Eraly CT Score. Lancet 355:1670

    Article  CAS  PubMed  Google Scholar 

  9. Parsons MW, Pepper EM, Chan V et al (2005) Perfusion computed tomography: prediction of final infarct extent and stroke outcome. Ann Neurol 58:672

    Article  PubMed  Google Scholar 

  10. Menon BK, d’Esterre CD, Qazi EM et al (2015) Multiphase CT angiography: a new tool for the imaging triage of patients with acute ischemic stroke. Stroke 46:3020–3035

    Google Scholar 

  11. Goyal M, Demchuk AM, Menon BK et al (2015) Randomized assessment of rapid endovascular treatment of ischaemic stroke. N Engl J Med 372:1019

    Article  CAS  PubMed  Google Scholar 

  12. Allmendinger AM, Tang ER, Lui YW, Spektor V (2012) Imaging of stroke: part 1, perfusion CT- overview of imaging technique, interpretation pearls, and common pitfalls. AJR Am J Roentgenol 198:52

    Article  PubMed  Google Scholar 

  13. Lev MH (2013) Perfusion imaging of acute stroke: its role in current and future clinical practice. Radiology 266:22

    Article  PubMed  Google Scholar 

  14. Fiebach JB, Schellinger PD, Gass A et al (2004) Stroke magnetic resonance imaging is accurate in hyperacute intracerebral haemorrhage: a multicentre study on the validity of stroke imaging. Stroke 35:502

    Article  PubMed  Google Scholar 

  15. Warach S, Gaa J, Siewert B et al (1995) Acute human stroke studied by whole brain echo planar diffusion-weighted magnetic resonance imaging. Ann Neurol 37:231

    Article  CAS  PubMed  Google Scholar 

  16. Schellinger PD, Bryan RN, Caplan LR et al (2010) Evidenced-based guideline: the role of diffusion and perfusion MRI for the diagnosis of acute ischemic stroke: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 75:177

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Hjort N, Butcher K, Davis SM et al (2005) Magnetic resonance imaging criteria for thrombolysis in acute cerebral infarct. Stroke 36:388

    Article  CAS  PubMed  Google Scholar 

  18. Beaulieu C, de Crespigny A, Tong DC et al (1999) Longitudinal magnetic resonance imaging study of perfusion and diffusion in stroke: evolution of lesion volume and correlation with clinical outcome. Ann Neurol 46:568

    Article  CAS  PubMed  Google Scholar 

  19. Neumann-Haefelin T, Wittsack HJ, Wenserski F et al (1999) Diffusion- and perfusion-weighted MRI. The DWI/PWI mismatch region in acute stroke. Stroke 30:1591

    Article  CAS  PubMed  Google Scholar 

  20. Rordorf G, Koroshetz WJ, Copen WA et al (1998) Regional ischemia and ischemic injury in patients with acute middle cerebral artery stroke as defined by early diffusion-weighted and perfusion-weighted MRI. Stroke 29:939

    Article  CAS  PubMed  Google Scholar 

  21. Chalela JA, Kang DW, Luby M et al (2004) Early magnetic resonance imaging findings in patients receiving tissue plasminogen activator predict outcome: insights into the pathophysiology of acute stroke in the thrombolysis area. Ann Neurol 55:105

    Article  PubMed  Google Scholar 

  22. Latchaw RE, Alberts MJ, Lev MH et al (2009) Recommendations for imaging of acute ischemic stroke: a scientific statement from the American Heart Association. Stroke 40:3646

    Article  PubMed  Google Scholar 

  23. Rha JH, Saver JL (2007) The impact of recanalization on ischaemic stroke outcome: a meta-analysis. Stroke 38:967

    Article  PubMed  Google Scholar 

  24. Goyal M, Menon BK, Derdeyn CP (2013) Perfusion imaging in acute ischemic stroke: let us improve the science before changing clinical practice. Radiology 266:16

    Article  PubMed  Google Scholar 

  25. Zangerle A, Kiechl S, Spiegel M et al (2007) Recanalization after thrombolysis in stroke patients: predictors and prognostic implications. Neurology 68:39

    Article  CAS  PubMed  Google Scholar 

  26. Georgiadis D, Oehler J, Schwarz S et al (2004) Does acute occlusion of the carotid T invariably have a poor outcome? Neurology 63:22

    Article  CAS  PubMed  Google Scholar 

  27. Vidale S, Arnaboldi M (2014) Treatment of basilar artery occlusion. Ann Neurol 74:161

    Article  Google Scholar 

  28. Burns JD, Green DM, Metivier K, DeFusco C (2012) Intensive care management of acute ischaemic stroke. Emerg Med Clin North Am 30:713

    Article  PubMed  Google Scholar 

  29. Kwiatkowski TG, Libman RB, Frankel M et al (1999) Effects of tissue plasminogen activator for acute ischaemic stroke at one year. National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator Stroke Study Group. N Engl J Med 340:1781

    Article  CAS  PubMed  Google Scholar 

  30. Hacke W, Kaste M, Bluhmki E et al (2008) Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med 359:1317

    Article  CAS  PubMed  Google Scholar 

  31. Wahlgren N, Ahmed N, Dávalos A et al (2008) Thrombolysis with Alteplase 3–4.5 h after acute ischaemic stroke (SITS-ISTR): an observational study. Lancet 372:1303

    Article  CAS  PubMed  Google Scholar 

  32. IST-3 collaborative group, Sandercock P, Wardlaw JM et al (2012) The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial. Lancet 379:2352

    Article  Google Scholar 

  33. Wardlaw JM, Murray V, Berge E et al (2012) Recombinant tissue plasminogen activator for acute ischaemic stroke: an updated systematic review and meta-analysis. Lancet 379:2364

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Emberson J, Lees KR, Lyden P et al (2014) Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with Alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials. Lancet 384:1929

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Saver JL, Fonarow GC, Smith EE et al (2013) Time to treatment with intravenous tissue plasminogen activator and outcome from acute ischaemic stroke. JAMA 309:2480

    Article  CAS  PubMed  Google Scholar 

  36. Vidale S, Agostoni E (2014) Thrombolysis in acute ischaemic stroke. Brain 137:e281

    Article  PubMed  Google Scholar 

  37. Furlan A, Higashida R, Wechsler L et al (1999) Intra-arterial prourokinase for acute ischaemic stroke. The PROACT II study: a randomized controlled trial Prolyse in Acute Cerebral Thromboembolism. JAMA 282:2003

    Article  CAS  PubMed  Google Scholar 

  38. Lee M, Hong KS, Saver JL (2010) Efficacy of intra-arterial fibrinolysis for acute ischemic stroke: meta-analysis of randomized controlled trials. Stroke 41:932

    Article  PubMed  Google Scholar 

  39. Ciccone A, Valvassori L, Nichelatti M et al (2013) Endovascular treatment for acute ischaemic stroke. N Engl J Med 368:904

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Broderick JP, Palesch YY, Demchuk AM et al (2013) Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. N Engl J Med 368:893

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Powers WJ, Derdeyn CP, Biller J et al (2015) AHA/ASA Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischaemic Stroke Regarding Endovascular Treatment: a Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 46(10):3020–3035

    Article  CAS  PubMed  Google Scholar 

  42. Berkhemer OA, Fransen PS, Beumer D et al (2015) A randomized trial of intra-arterial treatment for acute ischaemic stroke. N Engl J Med 372:11

    Article  PubMed  Google Scholar 

  43. Saver JL, Goyal M, Bonafe A et al (2015) Stent-retriever thrombectomy after intravenous t-PA vs t-PA alone in stroke. N Engl J Med 372:2285

    Article  CAS  PubMed  Google Scholar 

  44. Campbell BC, Mitchell PJ, Kleinig TJ et al (2015) Endovascular therapy for ischaemic stroke with perfusion-imaging selection. N Engl J Med 372:1009

    Article  CAS  PubMed  Google Scholar 

  45. Jovin TG, Chamorro A, Cobo E et al (2015) Thrombectomy within 8 hours after symptom onset in ischaemic stroke. N Engl J Med 372:2296

    Article  CAS  PubMed  Google Scholar 

  46. Prabhakaran S, Ruff I, Bernstein RA (2015) Acute stroke intervention: a systematic review. JAMA 313:1451

    Article  CAS  PubMed  Google Scholar 

  47. Campbell BC, Donnan GA, Lees KR et al (2015) Endovascular stent thrombectomy: the new standard of care for large vessel ischaemic stroke. Lancet Neurol 14:846

    Article  PubMed  Google Scholar 

  48. Hacke W (2015) Interventional thrombectomy for major stroke–a step in the right direction. N Engl J Med 372:76

    Article  PubMed  Google Scholar 

  49. The NINDS t-PA Stroke Study Group (1997) Intracerebral haemorrhage after intravenous t-PA therapy for ischaemic stroke. Stroke 28:2109

    Article  Google Scholar 

  50. Khatri P, Wechsler LR, Broderick JP (2007) Intracranial haemorrhage associated with revascularization therapies. Stroke 38:431

    Article  PubMed  Google Scholar 

  51. Whiteley WN, Slot KB, Fernandes P et al (2012) Risk factors for intracranial haemorrhage in acute ischaemic stroke patients treated with recombinant tissue plasminogen activator: a systematic review and meta-analysis of 55 studies. Stroke 43:2904

    Article  CAS  PubMed  Google Scholar 

  52. Miedema I, Luijckx GJ, De Keyser J et al (2012) Thrombolytic therapy for ischaemic stroke in patients using warfarin: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 83:537

    Article  PubMed  Google Scholar 

  53. Xian Y, Liang L, Smith EE et al (2012) Risks of intracranial hemorrhage among patients with cute ischemic stroke receiving warfarin and treated with intravenous tissue plasminogen activator. JAMA 307:2600

    Article  CAS  PubMed  Google Scholar 

  54. Reza Noorian A, Nogueira R, Gupta R (2011) Neuroprotection in acute ischaemic stroke. J Neurosurg Sci 55:127

    CAS  PubMed  Google Scholar 

  55. Sahota P, Savitz SI (2011) Investigational therapies for ischaemic stroke: neuroprotection and neurorecovery. Neurotherapeutics 8:434

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Brott TG, Halperin JL, Abbara S et al (2011) 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease. Circulation 124:e54

    Article  PubMed  Google Scholar 

  57. Ferguson GG, Eliasziw M, Barr HW et al (1999) The North American Symptomatic Carotid Endarterectomy Trial: surgical results in 1415 patients. Stroke 30:1751

    Article  CAS  PubMed  Google Scholar 

  58. Executive Committee for the ASYl11ptomatic Carotid Atherosclerosis Study (1995) Endarterectomy for asymptomatic carotid artery stenosis. JAMA 273:1421

    Article  Google Scholar 

  59. Huber R, Müller BT, Seitz RJ, Siebler M, Mödder U, Sandmann W (2003) Carotid surgery in acute symptomatic patients. Eur J Vasc Endovasc Surg 25:60

    Article  CAS  PubMed  Google Scholar 

  60. Paty PS, Darling RC 3rd, Feustel PJ et al (2004) Early carotid endarterectomy after acute stroke. J Vasc Surg 39:148

    Article  PubMed  Google Scholar 

  61. Brott TM, Hobson RW, Howard G et al (2010) Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med 363:11

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Rockman C (2004) Carotid endarterectomy in patients with contralateral carotid occlusion. Semin Vasc Surg 17:224

    Article  PubMed  Google Scholar 

  63. Dalainas I, Nano G, Bianchi P, Casana R, Malacrida G, Tealdi DG (2007) Carotid endarterectomy in patients with contralateral carotid artery occlusion. Ann Vasc Surg 21:16–22, Med 2010;363(1):11e23

    Article  PubMed  Google Scholar 

  64. Rockman CB, Su W, Lamparello PJ, Adelman MA, Jacobowitz GR, Gagne PJ et al (2002) A reassessment of carotid endarterectomy in the face of contralateral carotid occlusion: surgical results in symptomatic and asymptomatic patients. J Vasc Surg 36:668

    Article  PubMed  Google Scholar 

  65. Bond R, Rerkasem K, Counsell C, Salinas R, Naylor R, Warlow CP et al (2002) Routine or selective carotid artery shunting for carotid endarterectomy (and different methods of monitoring in selective shunting). Cochrane Database Syst Rev CD000190

    Google Scholar 

  66. Goodney PP, Wallaert JB, Scali ST et al (2012) Impact of practice patterns in shunt use during carotid endarterectomy with contralateral carotid occlusion. J Vasc Surg 62:61

    Article  Google Scholar 

  67. Collice M, Arena O, Fontana RA, Mola M, Galbiati N (1986) Role of EEG monitoring and cross-clamping duration in carotid endarterectomy. J Neurosurg 65:815

    Article  CAS  PubMed  Google Scholar 

  68. Grubb RL Jr, Powers WJ, Clarke WL et al (2013) Surgical results of the Carotid Occlusion Surgery Study. J Neurosurg 118:25

    Article  PubMed  Google Scholar 

  69. Ropper AH, Shafran B (1984) Brain edema after stroke: clinical syndrome and intracranial pressure. Arch Neurol 41:26

    Article  CAS  PubMed  Google Scholar 

  70. Schwab S, Aschoff A, Spranger M et al (1996) The value of ICP monitoring in acute hemispheric stroke. Neurology 47:393

    Article  CAS  PubMed  Google Scholar 

  71. Poca MA, Benejam B, Sahuquillo J et al (2010) Monitoring intracranial pressure in patients with malignant middle cerebral artery infarction: is it useful? J Neurosurg 112:648

    Article  PubMed  Google Scholar 

  72. Flores SC, Berge E, Whittle IR (2012) Surgical decompression for cerebral edema in acute ischaemic stroke Cochrane Database Syst Rev 1:CD003435. doi:10.1002/14651858.CD003435

Download references

Author information

Authors and Affiliations

  1. Division of Stroke Unit and Neurological Emergiences, Sant’Anna Hospital, Como, Italy

    Simone Vidale MD & Luca Valvassori MD

  2. Department of Neurosurgery, Department of Neuroscience, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy

    Giuseppe D’Aliberti MD

Authors
  1. Simone Vidale MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Giuseppe D’Aliberti MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Luca Valvassori MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Luca Valvassori MD .

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Vidale, S., D’Aliberti, G., Valvassori, L. (2017). Brief Description of Recent Developments in Diagnosis and Treatment. In: Ischemic Stroke. Emergency Management in Neurology. Springer, Cham. https://doi.org/10.1007/978-3-319-31705-2_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-31705-2_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-31704-5

  • Online ISBN: 978-3-319-31705-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation