Acute stroke management
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Stroke disease is the second leading cause of death in the world. Even if stroke incidence remains stable, the number of new acute strokes in Europe is projected to increase markedly by 2025. In 2007, the SITS-MOST trial provided the first conclusive evidence that intravenous thrombolysis with recombinant tissue plasminogen activator (rTPA) was beneficial in the acute period for patients with cerebral infarct. Evidence from the same year showed that decompressive hemicraniectomy can double the rate of survival with a favourable outcome for young patients with malignant middle-cerebral artery infarct. These studies and others from that period altered the landscape of stroke management dramatically. Reperfusion has become a central component of acute stroke strategy and neurosurgical intervention for acute stroke has become commonplace in many European centres.
In this month’s journal club, we review three papers which aim to refine or expand our current use of acute interventions for...