Department of Neurology, Tulane University School of Medicine, 1430 Tulane Avenue 8065, New Orleans, LA 70112, USA.
Neurol Clin. 2012 Feb;30(1):187-210, ix. doi: 10.1016/j.ncl.2011.09.014. Epub 2011 Oct 20.
The past 40 years have seen the evolution of acute ischemic stroke management from unproven therapies du jour, such as steroids, heparin for stroke in evolution, and hypervolemic-hemodilution, to more of a scientific basis for our decision-making process. This evolution is directly related to the advancements in imaging of stroke. It is also related to carefully designed, controlled clinical trials of potential therapies, which have led to the recognition of the benefits of thrombolytic therapy in the acute setting but have also caused confusion and frustration over the lack of benefit for potential neuroprotective agents that once seemed promising.
过去的 40 年见证了急性缺血性脑卒中管理的演变，从当时未经证实的疗法，如类固醇、进展性脑卒中的肝素治疗和高血容量血液稀释，到更具决策过程科学依据的疗法。这种演变与脑卒中成像的进步直接相关。它也与潜在治疗方法的精心设计、对照临床试验相关，这些试验导致了急性治疗中溶栓治疗的益处得到认可，但也导致了曾经有希望的潜在神经保护剂缺乏益处的困惑和沮丧。
