Acute Stroke Intervention

This chapter summarizes important data that can guide therapy and outline techniques of acute stroke intervention. An acute ischemic stroke is the consequence of abrupt vessel occlusion. Generally, strokes are not accompanied by severe headache and the presence of this should raise immediate suspicion of intracranial hemorrhage. The main reason for immediate cerebral imaging is exclusion of intracranial hemorrhage and other stroke mimics such as space-occupying lesions. This can be performed with a noncontrast computed tomography (CT) scan or magnetic resonance imaging (MRI). There are only three main treatment categories in the acute phase of a stroke: intravenous lytic therapy, endovascular therapy with or without intravenous or intra-arterial lysis, and anticoagulation with or without antiplatelet therapy. Of these strategies, intravenous lysis is the only Food and Drug Administration (FDA)-approved treatment for patients in the 3-h time window.