In the last 15 years new therapeutic approaches have influenced the treatment of ischemic stroke victims. Aim of this review is to point out the elements of a modern approach to the acute stroke patient. The likelihood of saving ischemic cerebral tissue is time-dependent and the treatment goal is to minimise brain damage. The NINDS trial has documented a higher likelihood of better outcome if the fibrinolytic therapy is administered within 3 h of onset of symptoms. To reach this target several interventions are necessary. First of all, education is needed to diffuse public awareness of stroke warning signs. Moreover, out-of-hospital treatment should be optimised with rapid triage and transport to an hospital with a comprehensive stroke approach. The early hospital phase should comprehend a rapid evaluation and an urgent CT scan. After the verification of the inclusion/exclusion criteria, in a authorised SITS-MOST centre, the patient should receive fibrinolytic therapy. The diagnostic and the therapeutic phase should include rapid identification and treatment of secondary insults, as hyperthermia and hyperglycaemia, that have a negative influence on outcome. Despite advances in diagnosis and monitoring, fibrinolytic therapy is the only treatment with a proven efficacy in achieving a higher functional outcome. The narrow time-window is the reason for the need of rapid and well-organised out-of-hospital and in-hospital systems.
Citerio, G., Galli, D., Cadore, B., Rondelli, E., Sala, F., & Abbruzzese, C. (2006). How to improve ischemic stroke treatment in the fibrinolysis era. MINERVA ANESTESIOLOGICA, 72(6), 407-412.
|Citazione:||Citerio, G., Galli, D., Cadore, B., Rondelli, E., Sala, F., & Abbruzzese, C. (2006). How to improve ischemic stroke treatment in the fibrinolysis era. MINERVA ANESTESIOLOGICA, 72(6), 407-412.|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||No|
|Titolo:||How to improve ischemic stroke treatment in the fibrinolysis era|
|Autori:||Citerio, G; Galli, D; Cadore, B; Rondelli, E; Sala, F; Abbruzzese, C|
|Data di pubblicazione:||2006|
|Appare nelle tipologie:||01 - Articolo su rivista|