Acute Ischemic Stroke Management-The Updated 2018 Stroke Guidelines

Following publication of the 2013 Stroke Guidelines, revisions were made to the 2015 update after publication of randomized clinical studies with high levels of evidence. The 2018 guidelines on the early management of patients with ischemic stroke containing these revisions were provided online as an epub ahead of print on January 24, 2018, and were published in the March 2018 issue of Stroke (1). The DAWN (January 4, 2018) and DEFUSE-3 (February 22, 2018) studies published in The New England Journal of Medicine just before the release of the new guidelines prompted important revisions in the 2018 Stroke Guidelines (2, 3). In the DAWN study, among patients with acute stroke lastknown to be well 6-24 hours previously among patients with acute ischemic stroke who known to be well between 6 and 24 hours, and who had a discrepancy between the clinical deficit and infarct volume, the 90-day neurological outcomes were better in patients who underwent thrombectomy and were given standard care than in those who received standard care only (2).