Neurocritical Care

, Volume 17, Supplement 1, pp 29–36 | Cite as

Emergency Neurological Life Support: Acute Ischemic Stroke

  • Hartmut Gross
  • Gene Sung
  • Scott D. Weingart
  • Wade S. Smith
Review Article

Abstract

Acute ischemic stroke is a neurological emergency that can be treated with time-sensitive interventions, including intravenous thrombolysis and endovascular approaches. Extensive study has demonstrated that rapid assessment and treatment are essential to improving neurological outcome. For this reason, acute ischemic stroke was chosen as an Emergency Neurological Life Support protocol. The protocol focuses on the first hour following the onset of neurological deficit.

Keywords

Ischemic stroke Tissue plasminogen activator Protocol Algorithm ENLS 

References

  1. 1.
    Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation. 2011;123:e18–209.CrossRefPubMedGoogle Scholar
  2. 2.
    Adams HP Jr, del Zoppo G, Alberts MJ, et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke. 2007;38:1655–711.CrossRefPubMedGoogle Scholar
  3. 3.
    Intracerebral hemorrhage after intravenous t-PA therapy for ischemic stroke. The NINDS t-PA Stroke Study Group. Stroke; a journal of cerebral circulation. 1997;28:2109–18.Google Scholar
  4. 4.
    Del Zoppo GJ, Saver JL, Jauch EC, Adams HP Jr, American Heart Association Stroke Council. Expansion of the time window for treatment of acute ischemic stroke with intravenous tissue plasminogen activator: a science advisory from the American Heart Association/American Stroke Association. Stroke. 2009;40:2945–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Hacke W, Kaste M, Bluhmki E, et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med. 2008;359:1317–29.CrossRefPubMedGoogle Scholar
  6. 6.
    Easton JD, Saver JL, Albers GW, et al. Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists. Stroke. 2009;40:2276–93.CrossRefPubMedGoogle Scholar
  7. 7.
    Cucchiara B, Ross M. Transient ischemic attack: risk stratification and treatment. Ann Emerg Med. 2008;52:S27–39.CrossRefPubMedGoogle Scholar
  8. 8.
    Kennedy J, Hill MD, Ryckborst KJ, et al. Fast assessment of stroke and transient ischaemic attack to prevent early recurrence (FASTER): a randomised controlled pilot trial. Lancet Neurol. 2007;6:961–9.CrossRefPubMedGoogle Scholar

Copyright information

© Neurocritical Care Society 2012

Authors and Affiliations

  • Hartmut Gross
    • 1
  • Gene Sung
    • 2
  • Scott D. Weingart
    • 3
  • Wade S. Smith
    • 4
  1. 1.Department of Emergency MedicineMedical College of Georgia, Georgia Health Sciences UniversityAugustaUSA
  2. 2.Department of NeurologyUniversity of Southern CaliforniaLos AngelesUSA
  3. 3.ENLS Course Co-Chair, Division of ED Critical CareMount Sinai School of MedicineNew YorkUSA
  4. 4.ENLS Course Co-Chair, Department of NeurologyUniversity of CaliforniaSan FranciscoUSA

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