Diagnosis and management of acute ischemic stroke: speed is critical

Globally, stroke is the second leading cause of death.[1][1] The estimated 62 000 strokes that occur each year in Canada affect all age groups, from neonates to elderly people, with occurrence rates rising by age. The lifetime risk of overt stroke is estimated at one in four by age 80 years, and the

• Publication year

  2015

• Venue

  Canadian Medical Association Journal

• Publication date

  2015-09-08

• Fields of study

  Medicine

• Identifiers
  DOI 10.1503/cmaj.140355PMID 26243819PMCID PMC4562827
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• A randomized trial of intraarterial treatment for acute ischemic stroke.

  2015cited by this paper
• Canadian Stroke Best Practice Recommendations: Secondary Prevention of Stroke Guidelines, Update 2014

  2015cited by this paper
• Thrombectomy within 8 hours after symptom onset in ischemic stroke

  2015cited by this paper
• Endovascular therapy for ischemic stroke with perfusion-imaging selection.

  2015cited by this paper
• Thrombectomy within 8 hours after symptom onset in ischemic stroke.

  2015cited by this paper
• Canadian Stroke Best Practice Recommendations: Hyperacute Stroke Care Guidelines, Update 2015

  2015cited by this paper
• Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke.

  2015cited by this paper
• Effect of Treatment Delay, Age, and Stroke Severity on the Effects of Intravenous Thrombolysis with Alteplase for Acute Ischaemic Stroke: A Meta-analysis of Individual Patient Data from Randomized Trials

  2015cited by this paper
• Randomized assessment of rapid endovascular treatment of ischemic stroke.

  2015cited by this paper
• 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.

  2014cited by this paper
• Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials

  2014cited by this paper
• Heart disease and stroke statistics--2014 update: a report from the American Heart Association.

  2014cited by this paper
• Embolic strokes of undetermined source: the case for a new clinical construct.

  2014cited by this paper
• Fibrinolysis or primary PCI in ST-segment elevation myocardial infarction.

  2013cited by this paper
• 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.

  2013cited by this paper
• 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.

  2013cited by this paper
• Clopidogrel with aspirin in acute minor stroke or transient ischemic attack.

  2013cited by this paper
• CT/CT Angiography and MRI Findings Predict Recurrent Stroke After Transient Ischemic Attack and Minor Stroke: Results of the Prospective CATCH Study

  2012cited by this paper
• Prediction of haematoma growth and outcome in patients with intracerebral haemorrhage using the CT-angiography spot sign (PREDICT): a prospective observational study.

  2012cited by this paper
• Times From Symptom Onset to Hospital Arrival in the Get With The Guidelines–Stroke Program 2002 to 2009: Temporal Trends and Implications

  2012cited by this paper
• Reducing in-hospital delay to 20 minutes in stroke thrombolysis

  2012cited by this paper
• PHANTOM-S: The Prehospital Acute Neurological Therapy and Optimization of Medical Care in Stroke Patients – Study

  2012cited by this paper
• Addition of brain and carotid imaging to the ABCD2 score to identify patients at early risk of stroke after transient ischaemic attack: a multicentre observational study

  2011cited by this paper
• Addition of brain and carotid imaging to the ABCD² score to identify patients at early risk of stroke after transient ischaemic attack: a multicentre observational study.

  2010cited by this paper
• Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials.

  2010cited by this paper
• Population-based study からみた神経予後不良因子の検討

  2009cited by this paper
• Impact of a Stroke Unit on Length of Hospital Stay and In-Hospital Case Fatality

  2009cited by this paper
• Rapid Evaluation after High-Risk TIA is Associated with Lower Stroke Risk

  2009cited by this paper
• Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke.

  2008cited by this paper
• Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison.

  2007cited by this paper
• Stroke-unit care for acute stroke patients: an observational follow-up study.

  2007cited by this paper
• Early risk of stroke after transient ischemic attack: a systematic review and meta-analysis.

  2007cited by this paper
• Fast assessment of stroke and transient ischaemic attack to prevent early recurrence (FASTER): a randomised controlled pilot trial.

  2007cited by this paper
• A transient ischaemic attack clinic with round-the-clock access (SOS-TIA): feasibility and effects.

  2007cited by this paper
• Stroke Units in Their Natural Habitat: Systematic Review of Observational Studies

  2007cited by this paper
• Hyperacute MR imaging and clinical predictor risk score predict dependent outcome after minor stroke and TIA

  2007cited by this paper
• Time Is Brain—Quantified

  2006cited by this paper
• An evidence‐based causative classification system for acute ischemic stroke

  2005cited by this paper
• Imaging of the brain in acute ischaemic stroke: comparison of computed tomography and magnetic resonance diffusion-weighted imaging

  2005cited by this paper
• Safety and feasibility of prehospital thrombolysis in combination with active rescue PCI strategy for acute ST-elevation myocardial infarction.

  2005cited by this paper
• Eligibility for Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke: A Population-Based Study

  2004cited by this paper
• Comparison of MRI and CT for detection of acute intracerebral hemorrhage.

  2004cited by this paper
• ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients Wi

  2004cited by this paper
• The patient with transient cerebral ischemia: a golden opportunity for stroke prevention

  2004cited by this paper
• Lessons from the Stroke Prevention in Atrial Fibrillation Trials

  2003cited by this paper
• Transient ischemic attack--proposal for a new definition.

  2002cited by this paper
• Stroke units in Canada.

  2002cited by this paper
• Longitudinal trends in the severity of acute myocardial infarction: a population study in Olmsted County, Minnesota.

  2002cited by this paper
• Why are stroke patients excluded from TPA therapy?

  2001cited by this paper
• Why are stroke patients excluded from tPA therapy? An analysis of patient eligibility

  2001cited by this paper
• Short-term prognosis after emergency department diagnosis of TIA.

  2000cited by this paper
• Does the coronary care unit improve prognosis of patients with acute myocardial infarction? A thrombolytic era study.

  1999cited by this paper
• Diffusion MRI in patients with transient ischemic attacks.

  1999cited by this paper
• Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators.

  1998cited by this paper
• Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Second European-Australasian Acute Stroke Study Investigators.

  1998cited by this paper
• Collaborative systematic review of the randomised trials of organised inpatient (stroke unit) care after stroke

  1997cited by this paper
• Coronary plaque erosion without rupture into a lipid core. A frequent cause of coronary thrombosis in sudden coronary death.

  1996cited by this paper
• Tissue plasminogen activator for acute ischemic stroke.

  1995cited by this paper
• Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group.

  1995cited by this paper
• The effect of a stroke unit: reductions in mortality, discharge rate to nursing home, length of hospital stay, and cost. A community-based study.

  1995cited by this paper
• Benefit of a stroke unit: a randomized controlled trial.

  1991cited by this paper
• GISSI trial: early results and late follow-up. Gruppo Italiano per la Sperimentazione della Streptochinasi nell'Infarto Miocardico.

  1987cited by this paper
• A randomized trial of immediate versus delayed elective angioplasty after intravenous tissue plasminogen activator in acute myocardial infarction.

  1987cited by this paper
• Unstable angina with fatal outcome: dynamic coronary thrombosis leading to infarction and/or sudden death. Autopsy evidence of recurrent mural thrombosis with peripheral embolization culminating in total vascular occlusion.

  1985cited by this paper
• Lacunar strokes and infarcts

  1982cited by this paper
• Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction.

  1980cited by this paper
• The arterial lesions underlying lacunes

  1969cited by this paper
• Thrombolysis with fibrinolysin in cerebral arterial occlusion.

  1958cited by this paper

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