Acute Ischemic Stroke

Abstract

Anesthesiologists provide care to acute and subacute ischemic stroke (IS) patients and stroke survivors in interventional radiology, intensive care, and operating rooms. These encounters will become more frequent following studies that have extended the treatment window from last known well time for fibrinolytic and endovascular thrombectomy (EVT). The number of stroke centers certified to quickly and effectively initiate treatment of IS patients and the number of patients connected to them by telehealth continue to grow. This article reviews IS pathophysiology, assessment, treatment, pathology, and complications; anesthetic management during EVT; perioperative stroke management; and how anesthesia has an impact on patients with prior stroke.

Keywords: Alteplase; Decompressive hemicraniectomy; Hemorrhagic transformation; Ischemic stroke; Tenectaplase; Thrombectomy; Thrombolysis; Tissue plasminogen activator (tPA).