This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Broderick, J. P. Articles by Hacke, W. Search for Related Content PubMed PubMed Citation Articles by Broderick, J. P. Articles by Hacke, W. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Stroke Related Collections Acute Cerebral Infarction Emergency treatment of Stroke Thrombolysis Other Stroke Treatment - Medical

(Circulation. 2002;106:1563.)
© 2002 American Heart Association, Inc.

Clinical Cardiology: New Frontiers

Treatment of Acute Ischemic Stroke

Part I: Recanalization Strategies

Joseph P. Broderick, MD; Werner Hacke, MD, PhD

From the Department of Neurology (J.P.B.), University of Cincinnati College of Medicine, Cincinnati, Ohio; and the Department of Neurology (W.H.), University of Heidelberg, Heidelberg, Germany.

Correspondence to Joseph P. Broderick, MD, Dept of Neurology, University of Cincinnati College of Medicine, 231 Bethesda Ave, Cincinnati, Ohio 45267, M.L. 525. E-mail joseph.broderick@uc.edu

Key Words: cerebral infarction • stroke • thrombolysis

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
In 1994, a special writing group of the Stroke Council of the AHA published guidelines for the management of patients with acute ischemic stroke.¹ The guidelines, based on the best available evidence, focused primarily on the prevention and treatment of the complications of acute stroke such as cerebral edema and increased intracranial pressure, aspiration pneumonia, urinary tract infections, deep vein thrombosis and pulmonary embolism, decubiti, and seizures. The authors further concluded that "until more data are available, the use of heparin remains a matter of preference for the treating physician" and "that thrombolytic therapy is not currently recommended for the treatment of patients with acute ischemic stroke."¹ No supportive recommendations were given for any neuroprotective strategy, nor therapies given to stimulate neurological recovery.

In the 8 years since these guidelines were published, a large number of randomized studies of treatment strategies for acute stroke have been completed. These trials have included thrombolytic agents given intravenously, intra-arterially, or both, antithrombotic and antiplatelet therapies, neuroprotective agents, pharmacological and mechanical therapies to stimulate neurological recovery, and the use of stroke units. In addition, many pilot studies of new therapies for acute stroke have been reported and are entering Phase II and Phase III studies.

The current state of knowledge regarding the treatment of acute ischemic stroke that are based on these randomized studies can be summarized as follows. (1) Intravenous thrombolytic therapy, if administered within the first 3 hours after stroke, improves functional outcome after acute ischemic stroke. Even within the first 3 . . . [Full Text of this Article]

This article has been cited by other articles:

				M. M.A.L. Pelsers, T. Hanhoff, D. Van der Voort, B. Arts, M. Peters, R. Ponds, A. Honig, W. Rudzinski, F. Spener, J. R. de Kruijk, et al. Brain- and Heart-Type Fatty Acid-Binding Proteins in the Brain: Tissue Distribution and Clinical Utility Clin. Chem., September 1, 2004; 50(9): 1568 - 1575. [Abstract] [Full Text] [PDF]

				J. P. Broderick William M. Feinberg Lecture: Stroke Therapy in the Year 2025: Burden, Breakthroughs, and Barriers to Progress Stroke, January 1, 2004; 35(1): 205 - 211. [Abstract] [Full Text] [PDF]