Epidemiology, organization, diagnosis and treatment of acute ischemic stroke

Abstract

The management of acute ischemic stroke is changing. Over the period of 2010-2050, the number of incident strokes is expected to be more than double. Rapid access to mechanical thrombectomy for patients with large vessel occlusion is critically associated with their functional outcome. Moreover, patients with first pass effect had a better clinical outcome, lower mortality, and fewer procedural adverse events. We discuss some advances in acute ischemic stroke regarding the organization, the diagnosis and the treatment.

Keywords: Acute ischemic stroke.

Figure 1

Patient, in his sixty, with acute ischemic stroke within 24 h, with a Glasgow Coma Scale of 8. CT brain scan (A – B) showed ASPECTS 5. CT angiogram ( C) showed left M1 occlusion. CT perfusion with OLEA ( D) showed core of 116.959 cc and penumbra of 201.632 cc (mismatch 1.72). Endovascular treatment was performed with combination technique and a complete recanalization was achieved after 1 pass (E – F). CT scan ( G) after 24 h showed some ischemic lesions. At discharge, after 14 days, the NIHSS was 10.