Department of Neurology, University of Utah School of Medicine, 175 North Medical Drive, Salt Lake City, UT 84132, USA.
Department of Neurology, University of Utah School of Medicine, 175 North Medical Drive, Salt Lake City, UT 84132, USA.
Neurol Clin. 2022 Feb;40(1):17-32. doi: 10.1016/j.ncl.2021.08.002.
Ischemic stroke affects 2.5% of the population of the United States and is the leading cause of disability. This article outlines the evidence to support intravenous thrombolysis with alteplase and tenecteplase, thrombolysis in the setting of DWI/flair mismatch, endovascular treatment in the 6-hour and 6- to 24-hour window, and the use of telemedicine in acute stroke. Current controversies and ongoing trials within endovascular treatment are also detailed. Case presentations are included to provide clinical context and the application of data to practice.
缺血性脑卒中影响美国 2.5%的人口,是导致残疾的主要原因。本文概述了支持使用阿替普酶和替奈普酶进行静脉溶栓、DWI/Flair 不匹配时溶栓、6 小时及 6-24 小时窗内血管内治疗以及在急性脑卒中应用远程医疗的证据。还详细介绍了血管内治疗中当前的争议和正在进行的试验。病例介绍提供了临床背景和数据在实践中的应用。