Stroke: Acute stroke receiving facilities and management

Marek Humpich, Christian Byhahn, Raymond L. Fowler, Lise Labiche

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

PURPOSE OF REVIEW: Management of ischemic stroke is challenging. No prehospital treatment option exists, and the only approved pharmacologic therapy, that is, systemic thrombolysis, requires brain imaging and initiation of therapy within a narrow therapeutic window. This review provides an overview of recent efforts to optimize management of suspected stroke patients by reducing the interval from symptom onset to reperfusion therapy. RECENT FINDINGS: There is clear evidence that stroke patients have a favorable outcome when treated with thrombolysis in specialized stroke centers. Data from the European Cooperative Acute Stroke Study-III trial, coupled with improved patient selection by advanced imaging technologies will expand future therapeutic options. However, major obstacles remain in consistently translating scientific advances into clinical practice with only a small percentage of potentially eligible patients receiving thrombolysis. Integrated systems of prehospital management and clinical pathways are necessary to reduce this treatment gap. SUMMARY: The dogma 'time is brain' is as relevant now as it was at the inauguration of recombinant tissue plasminogen activator for acute stroke treatment in 1996. Knowledge of stroke symptoms and treatment options by the public and first responders, along with integrated stroke systems of care are crucial to ensure rapid access to stroke expertise and treatment.

Original languageEnglish (US)
Pages (from-to)295-300
Number of pages6
JournalCurrent Opinion in Critical Care
Volume15
Issue number4
DOIs
StatePublished - Aug 2009

Fingerprint

Stroke
Therapeutics
Critical Pathways
Tissue Plasminogen Activator
Neuroimaging
Patient Selection
Reperfusion
Technology
Brain

Keywords

  • Emergency
  • Prehospital treatment
  • Stroke
  • Telemedicine
  • Thrombolysis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Stroke : Acute stroke receiving facilities and management. / Humpich, Marek; Byhahn, Christian; Fowler, Raymond L.; Labiche, Lise.

In: Current Opinion in Critical Care, Vol. 15, No. 4, 08.2009, p. 295-300.

Research output: Contribution to journalArticle

Humpich, Marek ; Byhahn, Christian ; Fowler, Raymond L. ; Labiche, Lise. / Stroke : Acute stroke receiving facilities and management. In: Current Opinion in Critical Care. 2009 ; Vol. 15, No. 4. pp. 295-300.
@article{7e3c83c6f80a4097ad98e8a3ef9b9a94,
title = "Stroke: Acute stroke receiving facilities and management",
abstract = "PURPOSE OF REVIEW: Management of ischemic stroke is challenging. No prehospital treatment option exists, and the only approved pharmacologic therapy, that is, systemic thrombolysis, requires brain imaging and initiation of therapy within a narrow therapeutic window. This review provides an overview of recent efforts to optimize management of suspected stroke patients by reducing the interval from symptom onset to reperfusion therapy. RECENT FINDINGS: There is clear evidence that stroke patients have a favorable outcome when treated with thrombolysis in specialized stroke centers. Data from the European Cooperative Acute Stroke Study-III trial, coupled with improved patient selection by advanced imaging technologies will expand future therapeutic options. However, major obstacles remain in consistently translating scientific advances into clinical practice with only a small percentage of potentially eligible patients receiving thrombolysis. Integrated systems of prehospital management and clinical pathways are necessary to reduce this treatment gap. SUMMARY: The dogma 'time is brain' is as relevant now as it was at the inauguration of recombinant tissue plasminogen activator for acute stroke treatment in 1996. Knowledge of stroke symptoms and treatment options by the public and first responders, along with integrated stroke systems of care are crucial to ensure rapid access to stroke expertise and treatment.",
keywords = "Emergency, Prehospital treatment, Stroke, Telemedicine, Thrombolysis",
author = "Marek Humpich and Christian Byhahn and Fowler, {Raymond L.} and Lise Labiche",
year = "2009",
month = "8",
doi = "10.1097/MCC.0b013e32832e4566",
language = "English (US)",
volume = "15",
pages = "295--300",
journal = "Current Opinion in Critical Care",
issn = "1070-5295",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Stroke

T2 - Acute stroke receiving facilities and management

AU - Humpich, Marek

AU - Byhahn, Christian

AU - Fowler, Raymond L.

AU - Labiche, Lise

PY - 2009/8

Y1 - 2009/8

N2 - PURPOSE OF REVIEW: Management of ischemic stroke is challenging. No prehospital treatment option exists, and the only approved pharmacologic therapy, that is, systemic thrombolysis, requires brain imaging and initiation of therapy within a narrow therapeutic window. This review provides an overview of recent efforts to optimize management of suspected stroke patients by reducing the interval from symptom onset to reperfusion therapy. RECENT FINDINGS: There is clear evidence that stroke patients have a favorable outcome when treated with thrombolysis in specialized stroke centers. Data from the European Cooperative Acute Stroke Study-III trial, coupled with improved patient selection by advanced imaging technologies will expand future therapeutic options. However, major obstacles remain in consistently translating scientific advances into clinical practice with only a small percentage of potentially eligible patients receiving thrombolysis. Integrated systems of prehospital management and clinical pathways are necessary to reduce this treatment gap. SUMMARY: The dogma 'time is brain' is as relevant now as it was at the inauguration of recombinant tissue plasminogen activator for acute stroke treatment in 1996. Knowledge of stroke symptoms and treatment options by the public and first responders, along with integrated stroke systems of care are crucial to ensure rapid access to stroke expertise and treatment.

AB - PURPOSE OF REVIEW: Management of ischemic stroke is challenging. No prehospital treatment option exists, and the only approved pharmacologic therapy, that is, systemic thrombolysis, requires brain imaging and initiation of therapy within a narrow therapeutic window. This review provides an overview of recent efforts to optimize management of suspected stroke patients by reducing the interval from symptom onset to reperfusion therapy. RECENT FINDINGS: There is clear evidence that stroke patients have a favorable outcome when treated with thrombolysis in specialized stroke centers. Data from the European Cooperative Acute Stroke Study-III trial, coupled with improved patient selection by advanced imaging technologies will expand future therapeutic options. However, major obstacles remain in consistently translating scientific advances into clinical practice with only a small percentage of potentially eligible patients receiving thrombolysis. Integrated systems of prehospital management and clinical pathways are necessary to reduce this treatment gap. SUMMARY: The dogma 'time is brain' is as relevant now as it was at the inauguration of recombinant tissue plasminogen activator for acute stroke treatment in 1996. Knowledge of stroke symptoms and treatment options by the public and first responders, along with integrated stroke systems of care are crucial to ensure rapid access to stroke expertise and treatment.

KW - Emergency

KW - Prehospital treatment

KW - Stroke

KW - Telemedicine

KW - Thrombolysis

UR - http://www.scopus.com/inward/record.url?scp=68949187747&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=68949187747&partnerID=8YFLogxK

U2 - 10.1097/MCC.0b013e32832e4566

DO - 10.1097/MCC.0b013e32832e4566

M3 - Article

C2 - 19512918

AN - SCOPUS:68949187747

VL - 15

SP - 295

EP - 300

JO - Current Opinion in Critical Care

JF - Current Opinion in Critical Care

SN - 1070-5295

IS - 4

ER -