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Stroke Treatment
Author(s) -
Cronin C.A.,
Weisman C.J.,
Llinas R.H.
Publication year - 2008
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1196/annals.1444.013
Subject(s) - thrombolysis , medicine , stroke (engine) , neurology , tissue plasminogen activator , acute stroke , recombinant tissue plasminogen activator , emergency department , t plasminogen activator , emergency medicine , medical emergency , intensive care medicine , fibrinolytic agent , ischemic stroke , ischemia , psychiatry , myocardial infarction , mechanical engineering , modified rankin scale , engineering
For acute stroke patients who arrive at the hospital within 3 h of symptom onset, the focus of care involves screening for eligibility to receive intravenous tissue plasminogen activator. The publication of the National Institute of Neurological Disorders and Stroke recombinant tissue–type plasminogen activator (tPA, or alteplase) study in 1995 (Marler, J.R. 1995, New England Journal of Medicine 333 : 1581–1587) spurred protocol changes, which continue to evolve, throughout the health care system in an effort to streamline the patient through the Emergency Medical System. The need to expedite patient evaluation involving emergency department, laboratory, radiology, and clinical neurology testing is clear and has been a focus of many stroke centers. For some patients, intravenous thrombolysis within 3 h has a dramatic effect on outcome. However, that is not the only course of action for acute stroke patients. This article will review some of the effective treatments for stroke patients beyond the first 3 h of their care.