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Acute Treatment of Stroke (Except Thrombectomy)

  • Paula Muñoz Venturelli
  • Jason P. Appleton
  • Craig S. Anderson
  • Philip M. Bath
Stroke (H Diener, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Stroke

Abstract

Purpose of Review

The management of patients with acute stroke has been revolutionized in recent years with the advent of new effective treatments. In this rapidly evolving field, we provide an update on the management of acute stroke excluding thrombectomy, looking to recent, ongoing, and future trials.

Recent Findings

Large definitive trials have provided insight into acute stroke care including broadening the therapeutic window for thrombolysis, alternatives to standard dose alteplase, the use of dual antiplatelet therapy early after minor ischemic stroke, and treating elevated blood pressure in intracerebral hemorrhage. Further ongoing and future trials are eagerly awaited in this ever-expanding area.

Summary

Although definitive trials have led to improvements in acute stroke care, there remains a need for further research to improve our understanding of pathophysiological mechanisms underlying different stroke types with the potential for treatments to be tailored to the individual.

Keywords

Acute ischemic stroke Intracerebral hemorrhage Thrombolysis Antiplatelets Blood pressure Stroke unit 

Notes

Compliance with Ethical Standards

Conflict of Interest

Dr. Anderson reports grants from the National Health and Medical Research Council (NHMRC) of Australia, personal fees from Amgen, grants from Takeda China, and personal fees from Takeda China, outside the submitted work. Dr. Bath reports personal fees from Nestle, non-financial support and other from Platelet Solutions, personal fees and other from DiaMedica, and personal fees from Phagenesis, outside the submitted work. Dr. Muñoz Venturelli reports grants from FONDECYT Regular 2018, grants from Clínica Alemana de Santiago, and grants from The George Institute for Global Health, during the conduct of the study.

Dr. Appleton declares no potential conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Paula Muñoz Venturelli
    • 1
    • 2
    • 3
  • Jason P. Appleton
    • 4
    • 5
  • Craig S. Anderson
    • 1
    • 3
    • 6
  • Philip M. Bath
    • 4
    • 5
  1. 1.Clinical Research Center, Instituto de Ciencias e Innovación en Medicina, Facultad de MedicinaClínica Alemana Universidad del DesarrolloSantiagoChile
  2. 2.Department of Neurology and PsychiatryClínica Alemana de SantiagoSantiagoChile
  3. 3.The George Institute for Global HealthUniversity of New South WalesSydneyAustralia
  4. 4.Stroke Trials Unit, Division of Clinical NeurosciencesUniversity of NottinghamNottinghamUK
  5. 5.Stroke, Nottingham University Hospitals NHS TrustNottinghamUK
  6. 6.The George Institute China at Peking University Health Science CenterBeijingChina

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