Acute Ischemic Stroke Time, Penumbra, and Reperfusion

Therapies Tuesday, February 18th, 2014

STROKEAHA: January 7, 2014

Current guidelines advocate intravenous thrombolysis for patients with ischemic stroke <4.5 hours from onset without additional imaging beyond noncontrast computed tomography (CT) of the brain.1 Rapid administration of intravenous tissue-type plasminogen activator (IV-tPA) will reduce disability. Treatment of patients within 3 hours has an odds ratio of 1.53 (95% confidence interval, 1.26–1.86) for a favorable outcome (modified Rankin scale [mRS], 0–2) at 3 months.2However, this represents an absolute increase of 9% compared with placebo and is available to a minority of patients with ischemic stroke because of the rigid time constraints.3 Modern stroke imaging grants unprecedented access to the pathophysiology in individual patients with stroke. Read More

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