Stroke Branch, National Institute of Neurological Disorders and Stroke, Intramural Research Program, National Institutes of Health, Bethesda, MD, USA.
Neurotherapeutics. 2023 Apr;20(3):605-612. doi: 10.1007/s13311-023-01374-4. Epub 2023 May 2.
The field of vascular neurology has made tremendous advances over the last several decades, with major shifts in diagnosis, treatment, prevention, and rehabilitation of patients with stroke. Furthermore, the individuals who are providing the care represent a different cohort than those who were caring for stroke patients 30 years ago, with the increasing need for rapid decision-making for acute interventions and a larger workforce being needed to provide the many complicated aspects of care of stroke patients. Understanding the history of the field is critical before one can speculate about its future directions. In summarizing some of the past massive shifts in the past few decades, this review will discuss future opportunities and future challenges and will introduce the rest of this special issue focusing on vascular neurology in a post-thrombectomy era. Although thrombolysis and thrombectomy remain a major part of ischemic stroke management and care, in the coming years, there will likely be further modifications in how we provide the care, who provides it, how we train those individuals who provide it, where it is provided, and what data inform early management decisions.
在过去的几十年中,血管神经病学领域取得了巨大的进展,在中风患者的诊断、治疗、预防和康复方面都发生了重大转变。此外,提供护理的人员与 30 年前照顾中风患者的人员不同,他们需要更快地做出急性干预决策,并且需要更多的劳动力来提供中风患者护理的许多复杂方面。在推测该领域的未来方向之前,了解该领域的历史至关重要。在总结过去几十年中的一些重大转变时,本综述将讨论未来的机遇和挑战,并介绍本期特刊中专注于血管神经病学在后溶栓时代的其余部分。尽管溶栓和取栓仍然是缺血性中风管理和护理的主要部分,但在未来几年中,我们提供护理的方式、提供护理的人员、培训提供护理的人员的方式、提供护理的地点以及哪些数据为早期管理决策提供信息可能会进一步改变。