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12 - Ischemic Strokes

from Section 3 - Neurological Emergencies

Published online by Cambridge University Press:  02 November 2023

By
Joshua W. Joseph
Edited by
Kaushal Shah  and
Jarone Lee
Edited in association with
Clark G. Owyang  and
Benjamin Christian Renne
Kaushal Shah
Affiliation:
Weill Cornell Medical Center, New York
Jarone Lee
Affiliation:
Massachusetts General Hospital, Boston
Clark G. Owyang
Affiliation:
Weill Cornell Medical Center, New York
Benjamin Christian Renne
Affiliation:
Massachusetts General Hospital, Boston
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Summary

  • Cerebrovascular accident (CVA) or stroke is an interruption of blood supply due to thrombosis or embolization.

  • Thrombosis is caused by an in situ clot at a site of atherosclerotic plaque. Embolization is caused by an intravascular embolus. Sources include atrial fibrillation, ventricular aneurysm, hypokinetic ventricle, myocardial infarction, prosthetic valve, infective endocarditis and proximal friable atherosclerotic plaques.

Keywords

thrombosishemiplegiafacial droophead CTthrombolytics
Type
Chapter
Information
Practical Emergency Resuscitation and Critical Care , pp. 101 - 113
Publisher: Cambridge University Press
Print publication year: 2023

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References

Demaerschalk, BM, Kleindorfer, DO, Adeoye, OM, et al. Scientific rationale for the inclusion and exclusion criteria for intravenous alteplase in acute ischemic stroke: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2016;47(2):581–641.CrossRefGoogle ScholarPubMed
Ma, H, Campbell, BC, Parsons, MW, et al. Thrombolysis guided by perfusion imaging up to 9 hours after onset of stroke. New Engl J Med 2019;380(19):1795–1803.CrossRefGoogle ScholarPubMed
National Institutes of Health. NIH Stroke Scale. Bethesda, MD: National Institutes of Health, National Institute of Neurological Disorders and Stroke; 2013. Available from: http://stroke.nih.gov/documents/NIH_Stroke_Scale.pdf [last accessed February 15, 2023].Google Scholar
Phipps, MS, Cronin, CA. Management of acute ischemic stroke. BMJ 2020;368.Google ScholarPubMed
Powers, WJ. Acute ischemic stroke. New Engl J Med 2020;383(3):252–260.CrossRefGoogle ScholarPubMed
Powers, WJ, Rabinstein, AA, Ackerson, T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2019;50(12):e344–e418.CrossRefGoogle Scholar

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