Venkatasubba Rao Chethan P, Suarez Jose I
Continuum (Minneap Minn). 2018 Dec;24(6):1658-1682. doi: 10.1212/CON.0000000000000670.
This article provides updated information regarding the diagnosis and treatment (specifically critical care management) of acute ischemic stroke. This article also discusses the increased use of thrombolysis and thrombectomy in clinical practice.
Stroke is the leading cause of disability in the United States. A significant proportion of patients with acute ischemic stroke require critical care management. Much has changed in the early evaluation and treatment of patients presenting with acute ischemic stroke. The introduction of embolectomy in large vessel occlusions for up to 24 hours post-symptom onset has resulted in one in every three eligible patients with acute ischemic stroke with the potential to lead an independent lifestyle. These patients increasingly require recognition of complications and initiation of appropriate interventions as well as earlier admission to dedicated neurocritical care units to ensure better outcomes.
This article emphasizes issues related to the management of patients with acute ischemic stroke undergoing mechanical thrombectomy and thrombolysis and addresses the complex physiologic changes affecting neurologic and other organ systems.
本文提供了关于急性缺血性中风诊断和治疗（特别是重症监护管理）的最新信息。本文还讨论了临床实践中溶栓和取栓治疗使用的增加情况。
中风是美国致残的主要原因。相当一部分急性缺血性中风患者需要重症监护管理。急性缺血性中风患者的早期评估和治疗发生了很大变化。症状发作后长达24小时内在大血管闭塞中引入取栓术，使得每三名符合条件的急性缺血性中风患者中就有一名有可能过上独立生活。这些患者越来越需要识别并发症并启动适当干预措施，以及更早入住专门的神经重症监护病房以确保更好的治疗效果。
本文强调了与接受机械取栓和溶栓治疗的急性缺血性中风患者管理相关的问题，并探讨了影响神经和其他器官系统的复杂生理变化。
