Stroke. 2005;36:916-923
doi: 10.1161/01.STR.0000163257.66207.2d
doi: 10.1161/01.STR.0000163257.66207.2d
(Stroke. 2005;36:916.)
© 2005 American Heart Association, Inc.
AHA/ASA Scientific Statement |
Guidelines for the Early Management of Patients With Ischemic Stroke
2005 Guidelines Update A Scientific Statement From the Stroke Council of the American Heart Association/American Stroke Association
Key Words: AHA/ASA Scientific Statements • stroke • thrombolytic therapy • anticoagulation • evaluation
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
This article serves as an update of "Guidelines for the Early Management of Patients With Ischemic Stroke," published in Stroke in 2003 (http://stroke.ahajournals.org/cgi/content/full/34/4/1056). This update is intended to reflect advances in the field since the publication of the full guidelines. See Tables 1 and 2
, reprinted in this article from the 2003 document, for explanations of grade (strength of recommendation).
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Brain Imaging
CT remains the most widely used neuroimaging technique for the evaluation of patients with suspected acute ischemic stroke. Quantitative CT-based scoring systems (eg, the Alberta Stroke Program Early CT Score [ASPECTS]) are useful for identifying patients who are unlikely to recover fully despite thrombolytic therapy.1 Substantial agreement between the ASPECTS rating performed in real time and the score obtained later by an expert can be achieved when used by an experienced reader, but correlations are not perfect (weighted 
0.69, 95% CI 0.59 to 0.79).2 This scoring system has not been assessed in general clinical practice and is limited to use in patients with infarctions suspected to be in the distribution of the middle cerebral artery. In addition, advances in CT technology, including the development of CT angiography and perfusion studies, may affect future recommendations about the use of CT in the evaluation of patients with suspected stroke.
MRI techniques also are used widely in the assessment of patients with suspected stroke or transient ischemic attack (TIA). For example, a retrospective analysis of patients having
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Stroke 2003 34: 1056-1083.
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