Akutbehandlung des ischämischen Schlaganfalls

TY - JOUR

T1 - Akutbehandlung des ischämischen Schlaganfalls

T2 - Aktuelle Standards

AU - Barow, Ewgenia

AU - Thomalla, Götz

PY - 2019/10

Y1 - 2019/10

N2 - Important milestones of acute ischemic stroke (AIS) treatment were achieved in recent years. The results of two randomized controlled trials revealed that intravenous thrombolysis is efficacious for treatment of AIS patients with a symptom onset <9 h or an unknown time of symptom onset in the presence of beneficial patterns in advanced stroke imaging. These patterns comprise the evidence of salvageable tissue at risk of infarction in perfusion of computed tomography (so-called penumbral imaging) or a mismatch between the diffusion-weighted imaging (DWI) und fluid-attenuated inversion recovery (FLAIR) sequences in magnetic resonance imaging (so-called DWI-FLAIR mismatch). Another two randomized controlled trials resulted in evidence of a high effectiveness of mechanical thrombectomy using advanced imaging of selected AIS patients with a symptom onset <24 h or an unknown time window. This article provides an overview of the current study results and recommendations for the selection of imaging for evidence-based effective acute treatment of stroke patients.

AB - Important milestones of acute ischemic stroke (AIS) treatment were achieved in recent years. The results of two randomized controlled trials revealed that intravenous thrombolysis is efficacious for treatment of AIS patients with a symptom onset <9 h or an unknown time of symptom onset in the presence of beneficial patterns in advanced stroke imaging. These patterns comprise the evidence of salvageable tissue at risk of infarction in perfusion of computed tomography (so-called penumbral imaging) or a mismatch between the diffusion-weighted imaging (DWI) und fluid-attenuated inversion recovery (FLAIR) sequences in magnetic resonance imaging (so-called DWI-FLAIR mismatch). Another two randomized controlled trials resulted in evidence of a high effectiveness of mechanical thrombectomy using advanced imaging of selected AIS patients with a symptom onset <24 h or an unknown time window. This article provides an overview of the current study results and recommendations for the selection of imaging for evidence-based effective acute treatment of stroke patients.

U2 - 10.1007/s00115-019-0776-5

DO - 10.1007/s00115-019-0776-5

M3 - SCORING: Review

C2 - 31407046

VL - 90

SP - 979

EP - 986

JO - NERVENARZT

JF - NERVENARZT

SN - 0028-2804

IS - 10

ER -