Abstract and Introduction
Abstract
The initial management of a patient with suspected stroke necessitates a rapid and focused evaluation. Establishing the time of symptom onset, performing a focused neurologic examination, and interpreting ancillary tests facilitates delivery of acute stroke therapies to eligible patients. This review emphasizes the fundamentals of urgent stroke evaluation and evidence-based acute ischemic stroke therapies. Results from randomized clinical trials of intravenous thrombolysis, glucose management, and blood pressure management in acute ischemic stroke patients will be highlighted. External ultrasound as an adjunct to intravenous thrombolysis and treatment of those patients that wake up with stroke symptoms will also be discussed.
Introduction
Acute ischemic stroke is a medical emergency. Patients with suspected stroke require urgent evaluation to identify those who may be eligible for time-sensitive therapies. Safe and effective treatment of acute ischemic stroke requires determination of the time of symptom onset, performance of a focused neurologic examination, and rapid interpretation of ancillary tests. This review will emphasize the fundamentals of urgent acute stroke evaluation and evidence-based ischemic stroke therapies. Results from randomized clinical trials of systemic thrombolysis, glucose management, and blood pressure management related to acute ischemic stroke will be reviewed. External ultrasound as an adjunct to intravenous (IV) thrombolysis and treatment of those patients that wake up with stroke symptoms will also be discussed.