학술논문

Current practice and future directions in the diagnosis and acute treatment of ischaemic stroke
Document Type
Academic Journal
Source
The Lancet. Oct 6, 2018, Vol. 392 Issue 10154, 1247
Subject
Alberta
Canada
Language
English
ISSN
0140-6736
Abstract
Byline: Charlotte Zerna, MD (a), Prof Gotz Thomalla, MD (b), Bruce C V Campbell, MD (c), Prof Joung-Ho Rha, MD (d), Prof Michael D Hill, MD [michael.hill@ucalgary.ca] (e,f,g,h,*) Summary Even though stroke presents as a variety of clinical syndromes, neuroimaging is the most important biomarker to help differentiate between stroke subtypes and assess treatment eligibility. Therapeutic advances have led to intravenous thrombolysis with tissue-type plasminogen activator and endovascular treatment for proximal vessel occlusion in the anterior cerebral circulation being standard care for acute ischaemic stroke. Providing access to this care has implications for existing systems of care for stroke and their organisation and has reintroduced the possibility of adjuvant and neuroprotective treatment strategies in acute ischaemic stroke. The use of neuroimaging for patient selection and speed of diagnosis and delivery of treatment are the dominant themes of modern ischaemic stroke care. Author Affiliation: (a) Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (b) Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (c) Department of Medicine and Neurology, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia (d) Department of Neurology, Inha University Hospital School of Medicine, Incheon, Seoul, South Korea (e) Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (f) Department of Medicine, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (g) Department of Radiology, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (h) Department of Community Health Sciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada * Correspondence to: Prof Michael D Hill, Calgary Stroke Program, Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary and Foothills Hospital, Health Sciences Centre, Calgary, AB, T2N 4N1, Canada