Acute ischemic stroke: extending the time window

dysphagia in acute ischemic stroke

Introduction: Swallowing dysfunction complicates acute strokes in 25-32% of cases and directly affects patientschr('39') prognosis and recovery. Dysphagia complicates the course of acute strokes through its potential of the development of chest infection, nutritional problems, and dehydration.  Dysphagia is also an independent predictor of respiratory morbidity and mortality in acute stroke. In...

[Therapeutic time window in ischemic stroke].

近年,脳梗塞の治療では心筋梗塞の治療と同様に早 期診断・早期治療の重要性が叫ばれ,心筋梗塞が “Heart Attack”と呼ばれ可急的速やかに治療され一命 をとりとめるように,脳梗塞も“Brain Attack”と捉え 同様に速やかに治療を行い,後遺症を最小限にくいと めることの重要性が認識されつつある.脳虚血が発症 して脳血流が遮断されると脳組織は数時間で不可逆性 の変化をきたし壊死に陥って梗塞となる.ひとたび脳 梗塞に罹患すると片麻痺や言語障害などの神経症候, 記憶・記銘力の低下や情緒障害などの精神症状,さら にQOLの低下や痴呆症などの後遺症に苦しむことに なり社会的生命を失うことにもなる. 近年CT(computed tomography),MRI・A(magnetic resonance imaging・angiography),SPECT(single photon e...

Extending the window for thrombolysis in acute stroke.

Evolution of the Thrombolytic Treatment Window for Acute Ischemic Stroke

Ischemic stroke is a major cause of morbidity and mortality for which the only approved treatment in the acute setting is intravenous thrombolysis. The efficacy and safety of recombinant tissue plasminogen activator (rt-PA) have been firmly established within 3 h of symptom onset; however, few patients are eligible for treatment in this time window. Expanding the time for treatment has been cha...

O10: Thrombo-Inflammation in Acute Ischemic Stroke

Ischemic stroke has been classified as a merely thrombotic disease, so the main goal of its treatment is the recanalization of the occluded vasculature. However, despite fast restoration of blood circulation, progressive stroke still develops in many patients, which has led to the concept of reperfusion injury.  The underlying mechanism is only partly known. Though, it is accepted now, tha...