[Acute ischemic stroke: time is brain!].

Care of patients with acute ischemic stroke in dedicated stroke units reduces the rates of death and disability independently from any specific treatment. The only validated treatment for acute ischemic stroke is thrombolysis with intravenous alteplase. Its efficacy is strongly time-dependent. It is currently demonstrated for an administration up to 3 hours after symptom onset. Intravenous fibrinolysis for acute ischemic stroke is associated with an increased risk of symptomatic intracerebral haemorrhage. This can be reduced by rigorous application of recommendations for drug prescription. The efficacy of intravenous alteplase is relatively weak in patients with large artery occlusion. Combined therapies, using transcranial ultrasound, intraarterial thrombolysis, or clot retrieval devices are being evaluated to improve the efficacy of thrombolysis.