Stroke. 2003;34:1056-1083
doi: 10.1161/01.STR.0000064841.47697.22
doi: 10.1161/01.STR.0000064841.47697.22
(Stroke. 2003;34:1056.)
© 2003 American Heart Association, Inc.
ASA Scientific Statement |
Guidelines for the Early Management of Patients With Ischemic Stroke
A Scientific Statement From the Stroke Council of the American Stroke Association
Key Words: stroke • ASA Scientific Statement
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
In 1994, a panel appointed by the Stroke Council of the American Heart Association authored guidelines for the management of patients with acute ischemic stroke.1 After the approval of the use of intravenous recombinant tissue plasminogen activator (rtPA) for treatment of acute ischemic stroke by the Food and Drug Administration, the guidelines were supplemented by a series of recommendations 2 years later.2 Several promising interventions for the treatment of acute ischemic stroke have subsequently been tested in clinical trials, and other components of acute management have been evaluated since the previous guidelines were published. These new data have prompted the present revision of the prior guideline statement.
The goal of these guidelines is to provide updated recommendations that can be used by primary care physicians, emergency medicine physicians, neurologists, and other physicians who provide acute stroke care from admission to an emergency department through the first 24 to 48 hours of hospitalization by addressing the diagnosis and emergent treatment of the acute ischemic stroke in addition to the management of its acute and subacute neurological and medical complications.
Several groups have now written statements about management of stroke.3–7 These statements also include recommendations about public educational programs, the organization of stroke resources, and other aspects of patient management. For example, the Brain Attack Coalition published recommendations for organizing stroke services in a community, and the recommendations of the American Heart Association Emergency Cardiovascular Care Committee provide an outline for emergency medical services.6 The current panel elected not to duplicate these
GUIDELINES UPDATE
Stroke 2005 36: 916-923.
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 D. A. Regier, R. Sunderji, L. D. Lynd, K. Gin, and C. A. Marra Cost-effectiveness of self-managed versus physician-managed oral anticoagulation therapy. Can. Med. Assoc. J., June 20, 2006; 174(13): 1847 - 1852. [Abstract] [Full Text] [PDF]
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P. Khatri and S. E. Kasner Ischemic strokes after cardiac catheterization: opportune thrombolysis candidates? Arch Neurol, June 1, 2006; 63(6): 817 - 821. [Abstract] [Full Text] [PDF]
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E. Bandera, M. Botteri, C. Minelli, A. Sutton, K. R. Abrams, and N. Latronico Cerebral Blood Flow Threshold of Ischemic Penumbra and Infarct Core in Acute Ischemic Stroke: A Systematic Review Stroke, May 1, 2006; 37(5): 1334 - 1339. [Abstract] [Full Text] [PDF]
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R.G. Gonzalez Imaging-guided acute ischemic stroke therapy: From "time is brain" to "physiology is brain". AJNR Am. J. Neuroradiol., April 1, 2006; 27(4): 728 - 735. [Abstract] [Full Text] [PDF]
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 P L Tan, D King, C J Durkin, T M Meagher, and D Briley Diffusion weighted magnetic resonance imaging for acute stroke: practical and popular. Postgrad. Med. J., April 1, 2006; 82(966): 289 - 292. [Abstract] [Full Text] [PDF]
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B. S. Jacobs, G. Birbeck, A. J. Mullard, S. Hickenbottom, R. Kothari, S. Roberts, and M. J. Reeves Quality of hospital care in African American and white patients with ischemic stroke and TIA Neurology, March 28, 2006; 66(6): 809 - 814. [Abstract] [Full Text] [PDF]
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R. L. Sacco, R. Adams, G. Albers, M. J. Alberts, O. Benavente, K. Furie, L. B. Goldstein, P. Gorelick, J. Halperin, R. Harbaugh, et al. Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline. Circulation, March 14, 2006; 113(10): e409 - e449. [Abstract] [Full Text] [PDF]
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H. F. McGruder, J. B. Croft, and Z.-J. Zheng Characteristics of an "Ill-Defined" Diagnosis for Stroke: Opportunities for Improvement Stroke, March 1, 2006; 37(3): 781 - 789. [Abstract] [Full Text] [PDF]
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P. J. Hand, J. A. Haisma, J. Kwan, R. I. Lindley, B. Lamont, M. S. Dennis, and J. M. Wardlaw Interobserver Agreement for the Bedside Clinical Assessment of Suspected Stroke Stroke, March 1, 2006; 37(3): 776 - 780. [Abstract] [Full Text] [PDF]
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L. B. Goldstein Improving the Clinical Diagnosis of Stroke Stroke, March 1, 2006; 37(3): 754 - 755. [Full Text] [PDF]
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R. L. Sacco, R. Adams, G. Albers, M. J. Alberts, O. Benavente, K. Furie, L. B. Goldstein, P. Gorelick, J. Halperin, R. Harbaugh, et al. Guidelines for Prevention of Stroke in Patients With Ischemic Stroke or Transient Ischemic Attack: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Council on Stroke: Co-Sponsored by the Council on Cardiovascular Radiology and Intervention: The American Academy of Neurology affirms the value of this guideline. Stroke, February 1, 2006; 37(2): 577 - 617. [Abstract] [Full Text] [PDF]
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M. Vargas, J. P. Horcajada, V. Obach, M. Revilla, A. Cervera, F. Torres, A. M. Planas, J. Mensa, and A. Chamorro Clinical Consequences of Infection in Patients With Acute Stroke: Is It Prime Time for Further Antibiotic Trials? Stroke, February 1, 2006; 37(2): 461 - 465. [Abstract] [Full Text] [PDF]
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P.W. Schaefer, L. Roccatagliata, C. Ledezma, B. Hoh, L.H. Schwamm, W. Koroshetz, R.G. Gonzalez, and M.H. Lev First-Pass Quantitative CT Perfusion Identifies Thresholds for Salvageable Penumbra in Acute Stroke Patients Treated with Intra-arterial Therapy AJNR Am. J. Neuroradiol., January 1, 2006; 27(1): 20 - 25. [Abstract] [Full Text] [PDF]
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T. G. Phan, V. Srikanth, D. C. Reutens, T. T. de Abreu, S. Mateus, J. Correia, and M. J. Alberts Therapeutic Implications for Routine Transthoracic Echocardiography in Acute Ischemic Stroke Patients Stroke, January 1, 2006; 37(1): 11 - 12. [Full Text] [PDF]
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Part 9: Adult Stroke Circulation, December 13, 2005; 112(24_suppl): IV-111 - IV-120. [Full Text] [PDF]
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 Prepared by: British Cardiac Society, British Hype JBS 2: Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice Heart, December 1, 2005; 91(suppl_5): v1 - v52. [Full Text] [PDF]
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Part 9: Stroke Circulation, November 29, 2005; 112(22_suppl): III-110 - III-104. [Full Text] [PDF]
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 C. A. Anderson, D. B. Arciniegas, and C. M. Filley Treatment of Acute Ischemic Stroke: Does It Impact Neuropsychiatric Outcome? J Neuropsychiatry Clin Neurosci, November 1, 2005; 17(4): 486 - 488. [Abstract] [Full Text] [PDF]
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L. G. Stead, R. M. Gilmore, W. W. Decker, A. L. Weaver, and R. D. Brown Jr Initial emergency department blood pressure as predictor of survival after acute ischemic stroke Neurology, October 25, 2005; 65(8): 1179 - 1183. [Abstract] [Full Text] [PDF]
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 K. O. Rynn, F. L. Hughes, and B. Faley An Emergency Department Approach to Drug Treatment of Hypertensive Urgency and Emergency Journal of Pharmacy Practice, October 1, 2005; 18(5): 363 - 376. [Abstract] [PDF]
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M. A. Smith, L. D. Lisabeth, D. L. Brown, and L. B. Morgenstern Gender comparisons of diagnostic evaluation for ischemic stroke patients Neurology, September 27, 2005; 65(6): 855 - 858. [Abstract] [Full Text] [PDF]
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J. A. Hinchey, T. Shephard, K. Furie, D. Smith, D. Wang, S. Tonn, and for the Stroke Practice Improvement Network Invest Formal Dysphagia Screening Protocols Prevent Pneumonia Stroke, September 1, 2005; 36(9): 1972 - 1976. [Abstract] [Full Text] [PDF]
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 R. G. Holloway, C. G. Benesch, W. S. Burgin, and J. B. Zentner Prognosis and Decision Making in Severe Stroke JAMA, August 10, 2005; 294(6): 725 - 733. [Abstract] [Full Text] [PDF]
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California Acute Stroke Pilot Registry (CASPR) Inv The impact of standardized stroke orders on adherence to best practices Neurology, August 9, 2005; 65(3): 360 - 365. [Abstract] [Full Text] [PDF]
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M. J. Alberts, R. E. Latchaw, W. R. Selman, T. Shephard, M. N. Hadley, L. M. Brass, W. Koroshetz, J. R. Marler, J. Booss, R. D. Zorowitz, et al. Recommendations for Comprehensive Stroke Centers: A Consensus Statement From the Brain Attack Coalition Stroke, July 1, 2005; 36(7): 1597 - 1616. [Abstract] [Full Text] [PDF]
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A. Chamorro, J.P. Horcajada, V. Obach, M. Vargas, M. Revilla, F. Torres, A. Cervera, A.M. Planas, and J. Mensa The Early Systemic Prophylaxis of Infection After Stroke Study: A Randomized Clinical Trial Stroke, July 1, 2005; 36(7): 1495 - 1500. [Abstract] [Full Text] [PDF]
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T. T. de Abreu, S. Mateus, and J. Correia Therapy Implications of Transthoracic Echocardiography in Acute Ischemic Stroke Patients Stroke, July 1, 2005; 36(7): 1565 - 1566. [Abstract] [Full Text] [PDF]
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L. B. Goldstein and D. L. Simel Is This Patient Having a Stroke? JAMA, May 18, 2005; 293(19): 2391 - 2402. [Abstract] [Full Text] [PDF]
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