TREATMENT OF ACUTE ISCHEMIC STROKE

Efficacy of stroke treatment is closely related to the lapse of time. Within 3-6 hours after onset thrombolysis can be taken into considerat ion, thereafter prevention of secondary complications comes to the for e. Current recommendation confines systemic thrombolysis in the caroti d territory to a highly selected group of stroke patients. In basilar occlusions there is an established indication for selective thrombolys is, if done by a skilled neuroradiologist. Basic therapy (blood pessur e monitoring, control of temperature and glucose levels, prevention of aspiration pneumonia and pulmonary embolism) is the most effective ke y to outcome improvement. Management of secondary neurological complic ations include treatment of postischemic brain edema by medical, physi cal and surgical measures and anticoagulation in distinct clinical sit uations such as progressive stroke, highgrade extra- and intracranial stenosis or artery dissection. Effective treatment of stroke patients is based on pathogenesis and requires neurovascular experience as well as adequate infrastructure.