Cardiology Search
Cardiology Cardiology
ischemic%20stroke
ISCHEMIC STROKE
Treatment Guideline Chart
Ischemic stroke occurs when a blood vessel supplying the brain is obstructed.
Consider stroke in any patient presenting with sudden focal neurological deficit or any alteration in level of consciousness.
Rapid evaluation is essential for sure of time-sensitive treatments.
Determine if patient's symptoms are due to stroke and exclude stroke mimics (eg migraine, hypertensive encephalopathy, hypoglycemia, seizures or post-ictal paresis); identify other conditions requiring immediate intervention and determine the potential causes of stroke.

Ischemic Stroke References

  1. Jellinger PS, Smith DA, Mehta AE, et al; AACE Task Force for Management of Dyslipidemia and Prevention of Atherosclerosis. American Association of Clinical Endocrinologists' guidelines for management of dyslipidemia and prevention of atherosclerosis. Endocr Pract. 2012 Mar-Apr;18(Suppl 1):1-78. https://www.ncbi.nlm.nih.gov. Accessed 4 Sep 2013. PMID: 22522068
  2. Adams HP, del Zoppo G, Alberts MJ, et al. Guidelines for the early management of adults with ischemic stroke. A guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups. Stroke. 2007 May;38(5):1655-1711. http://stroke.ahajournals.org. Accessed 16 May 2011. PMID: 17431204
  3. Adams HP. Secondary prevention of atherothrombotic events after ischemic stroke. Mayo Clin Proc. 2009;84(1):43-51. doi: 10.1016/S0025-6196(11)60807-0. PMID: 19121254
  4. Adams RJ, Albers G, Alberts MJ, et al. Update to the AHA/ASA recommendations for the prevention of stroke in patients with stroke and transient ischemic attack. Stroke. 2008 May;39(5):1647-1652. doi: 10.1161/STROKEAHA.107.189063. PMID: 18322260
  5. Alberts MJ, Ovbiagele B. Current strategies for ischemic stroke prevention: role of multimodal combination therapies. J Neurol. 2007 Oct;254(10):1414-1426. doi: 10.1007/s00415-007-0569-9. PMID: 17934879
  6. Albers GW, Amarenco P, Easton JD, et al. Antithrombotic and thrombolytic therapy for ischemic stroke: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest. 2008 Jun;133(Suppl 6):630S-669S. doi: 10.1378/chest.08-0720. PMID: 18574275
  7. Alexandrov AV, Wojner AW, Grotta JC. CLOTBUST: design of a randomized trial of ultrasound-enhanced thrombolysis for acute ischemic stroke [abstract]. J Neuroimaging. 2004 Apr;14(2):108-112. PMID: 15095554
  8. Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ. 2002 Jan;324(7329):71-86. doi: 10.1136/bmj.324.7329.71. PMID: 11786451
  9. Biller J. Antiplatelet therapy in ischemic stroke: variability in clinical trials and its impact on choosing the appropriate therapy. J Neurol Sci. 2009 Sep;284:1-9. doi: 10.1016/j.jns.2009.04.001. PMID: 19380153
  10. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009 Sep;361(12):1139-1151. doi: 10.1056/NEJMoa0905561. PMID: 19717844
  11. Camm AJ, Lip GY, De Caterina R, et al; ESC Committee for Practice Guidelines (CPG). 2012 Focused update of the ESC guidelines for the management of atrial fibrillation: an update of the 2010 ESC guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J. 2012;33(21):2719-2747. http://www.escardio.org. Accessed 15 Jun 2016. PMID: 22922413
  12. Coull BM, Williams LS, Goldstein LB, et al. Anticoagulants and antiplatelet agents in acute ischemic stroke: report of the Joint Stroke Guideline Development Committee of the American Academy of Neurology and the American Stroke Association (a division of the American Heart Association). Stroke. 2002 Jul;33(7):1934-1942. PMID: 12105379
  13. Del Zoppo GJ, Saver JL, Jauch EC, et al. Expansion of the time window for treatment of acute ischemic stroke with intravenous tissue plasminogen activator: a science advisory from the American Heart Association/American Stroke Association. Stroke. 2009 Aug;40(8):2945-2948. doi: 10.1161/STROKEAHA.109.192535. PMID: 19478221
  14. Furie KL, Goldstein LB, Albers GW, et al; American Heart Association Stroke Council; Council on Quality of Care and Outcomes Research; Council on Cardiovascular Nursing; Council on Clinical Cardiology; Council on Peripheral Vascular Disease. Oral antithrombotic agents for the prevention of stroke in nonvalvular atrial fibrillation: a science advisory for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2012 Dec;43(12):3442-3453. http://stroke.ahajournals.org/. Accessed 19 Nov 2012. PMID: 22858728
  15. Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack. A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011 Jan;42(1):227-276. http://stroke.ahajournals.org. Accessed 16 May 2011. PMID: 20966421
  16. Huang Y, Cheng Y, Wu J, et al. Cilostazol as an alternative to aspirin after ischaemic stroke: a randomised, double-blind, pilot study. Lancet Neurol. 2008 Jun;7(6):494-499. doi: 10.1016/S1474-4422(08)70094-2. PMID: 18456558
  17. Guyatt GH, Akl EA, Crowther M, et al. Executive summary: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012 Feb;141(Suppl 2):7S-47S. http://www.chestnet.org. Accessed 09 Mar 2012. PMID: 22315257
  18. Jauch EC, Saver JL, Adams HP Jr, et al; American Heart Association Stroke Council; Council on Cardiovascular Nursing; Council on Peripheral Vascular Disease; Council on Clinical Cardiology. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013 Mar;44(3):870-947. http://stroke.ahajournals.org. Accessed 24 Apr 2013. PMID: 23370205
  19. Jianu DC, Muresanu DF, Bajenaru O, et al. Cerebrolysin adjuvant treatment in Broca's aphasics following first acute ischemic stroke of the left middle cerebral artery. J Med Life. 2010 Jul;3(3):297-307. Accessed 29 Mar 2011. PMID: 20945821
  20. Ladurner G, Kalvach P, Moessler H. Neuroprotective treatment with cerebrolysin in patients with acute stroke: a randomised controlled trial. J Neural Transm. 2005 Mar;112(3):415-428. http://www.ncbi.nlm.nih.gov. Accessed 23 Mar 2011. PMID: 15583955
  21. Lindsay P, Bayley M, McDonald A, et al. Toward a more effective approach to stroke: Canadian Best Practice Recommendations for Stroke Care. CMAJ. 2008 May;178(1):1418-1425. doi: 10.1503/cmaj.071253. PMID: 18490636
  22. Lee WH, Chu CY, Hsu PC, et al. Comparison of antiplatelet and antithrombotic therapy for secondary prevention of ischemic stroke in patients with peripheral artery disease: population-based follow-up study in Taiwan. Circ J. 2012;77(4):1046-1052. http://jstage.jst.go.jp. Accessed 18 Feb 2013. PMID: 23269006
  23. Maegdefessel L, Spin JM, Azuma J, et al. New options with dabigatran etexilate in anticoagulant therapy. Vasc Health Risk Manag. 2010 May;6:339-349. http://www.ncbi.nlm.nih.gov. Accessed 09 Mar 2012. PMID: 20531953
  24. Ng PW, Huang CY, et al. Consensus statement on ischaemic stroke care in Hong Kong. Hong Kong Med J. 2004 Apr;10(2):124-129. PMID: 15075433
  25. Paciaroni M, Bogousslavsky J. Primary and secondary prevention of ischemic stroke. Eur Neurol. 2010;63(5):267-278. doi: 10.1159/000285183. PMID: 20357456
  26. Sherman DG. Stroke prevention in atrial fibrillation: pharmacological rate versus rhythm control. Stroke. 2007 Feb;38(Suppl 2):615-617. http://stroke.ahajournals.org. PMID: 17261701
  27. Shulga O, Bornstein N. Antiplatelets in secondary stroke prevention. Front Neurol. 2011 Jul;2:36. http://www.ncbi.nlm.nih.gov. Accessed 19 Oct 2012. PMID: 21772826
  28. The American Heart Association. 2005 International Consensus Conference on cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) science with treatment recommendations. Part 9: stroke. Circulation. 2005;112:III-110-III-104. http://circ.ahajournals.org/.
  29. Summers D, Leonard A, Wentworth D, et al. Comprehensive overview of nursing and interdisciplinary care of the acute ischemic stroke patient: a scientific statement from the American Heart Association. Stroke. 2009 Aug;40(8):2911-2944. doi: 10.1161/STROKEAHA.109.192362. PMID: 19478222
  30. Van der Worpp HB, van Gijn J. Acute ischemic stroke. N Engl J Med. 2007 Aug;357(6):572-579. http://www.nejm.org/doi/full/10.1056/NEJMcp072057. PMID: 17687132
  31. Wann LS, Curtis AB, Ellenbogen KA, et al. 2011 ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation (update on dabigatran): a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2011 Mar;57(11):1330-1337. doi: 10.1016/j.jacc.2011.01.010. PMID: 21324629
  32. Zhang C. Cerebrolysin enhances neurogenesis in the ischemic brain and improves functional outcome after stroke. J Neurosci Res. 2010 Nov;88(15):3275-3281. http://www.ncbi.nlm.nih.gov. Accessed 23 Mar 2011. PMID: 20857512
  33. Yew KS, Cheng E. Acute stroke diagnosis. Am Fam Physician. 2009 Jul;80(1):33-40. PMID: 19621844
  34. Biller J, Schneck M. Vascular diseases of the nervous system: ischemic cerebrovascular disease. In: Bradley W, Daroff R, Fenichel G, et al. Bradley: Neurology I Clinical practice. 5th. Philadelphia: Butterworth Heinemann Elsevier; 2008. http://www.mdconsult.com
  35. The Stroke Society of the Philippines. Guidelines for the Prevention, Treatment and Rehabilitation of Stroke. 5th ed. Quezon City, Philippines: The Stroke Society of the Philippines; 2010:10-111.
  36. MedWormhttp://www.medworm.com/rss/index.php/Cardiology/7/http://www.medworm.com/rss/medicalfeeds/specialities/Cardiology.xml
  37. MedWormhttp://www.medworm.com/rss/index.php/Neurology/25/http://www.medworm.com/rss/medicalfeeds/specialities/Neurology.xml
  38. Katzan IL. Antiplatelets in secondary stroke prevention. Cleveland Clinic. http://www.clevelandclinicmeded.com. Jan 2009. Accessed 19 Nov 2012.
  39. Cucchiarra BL, Messe SR. Antiplatelet therapy for secondary prevention of stroke. UpToDate. http://www.uptodate.com. 26 Sep 2012. Accessed 19 Nov 2012.
  40. National Stroke Foundation. Clinical guidelines for stroke management 2010. Stroke Foundation. http://strokefoundation.com.au. Sep 2010. Accessed 16 May 2011.
  41. Ministry of Health (MOH) Singapore. Clinical practice guidelines. Stroke and transient ischaemic attacks: assessment, investigation, immediate management and secondary prevention. MOH (Singapore). http://www.moh.gov.sg. Jul 2009. Accessed 16 May 2011.
  42. Ministry of Health Malaysia. Clinical practice guidelines: management of stroke. Academy of Medicine of Malaysia. http://www.acadmed.org.my. 2006.
  43. Anderson D, Larson D, Bluhm J, et al. Institute for Clinical Systems Improvement. Diagnosis and initial treatment of ischemic stroke. ICSI. https://www.icsi.org. Jul 2012. Accessed 20 Feb 2013.
  44. National Institute for Health and Care Excellence (NICE). Dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation. NICE. http://www.nice.org.uk. 2012. Accessed 29 Mar 2012.
  45. European Stroke Organisation. Guidelines for management of ischaemic stroke and transient ischaemic attack. ESO. http://www.eso-stroke.org. Mar 2008. Accessed 15 Dec 2009.
  46. Scottish Intercollegiate Guidelines Network (SIGN). Management of patients with stroke: rehabilitation, prevention and management of complications, and discharge planning. SIGN. http://www.sign.ac.uk. Jun 2010. Accessed 26 May 2011.
  47. National Collaborating Centre for Chronic Conditions (UK). Stroke: diagnosis and initial management of acute stroke and transient ischaemic attack (TIA). NICE. http://www.nice.org.uk. 2008.
  48. Berglund L, Brunzell JD, Goldberg AC, et al. Evaluation and treatment of hypertriglyceridemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2012 Sep;97(9):2969-2989. doi: 10.1210/jc.2011-3213. Accessed 04 Sep 2013. PMID: 22962670
  49. Culebras A, Messé SR, Chaturvedi S, et al. Summary of evidence-based guideline update: prevention of stroke in nonvalvular atrial fibrillation: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2014 Feb;82(8):716-724. doi: 10.1212/WNL. 0000000000000145. Accessed 27 Mar 2014. PMID: 24566225
  50. Kernan WN, Ovbiagale B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014 Jul;45(7):2160-2236. http://stroke.ahajournals.org. Accessed 23 Feb 2015. PMID: 24788967
  51. Powers WJ, Derdeyn CP, Biller J, et al. 2015 American Heart Association/American Stroke Association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015 Oct;46(10):3020-3035. doi: 10.1161/STR.0000000000000074. Accessed 11 Sep 2015. PMID: 26123479
  52. Wang Y, Wang Y, Zhao X, et al. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N Eng J Med. 2013 Jul;369(1):11-19. doi: 10.1056/NEJMoa1215340. Accessed 22 Sep 2015. PMID: 23803136
  53. Lane DA, Lip GY. Use of the CHA2DS2-VASc and HAS-BLED scores to aid decision making for thromboprophylaxis in nonvalvular atrial fibrillation. Circulation. 2012 Aug;126(7):860-865. doi: 10.1161/CIRCULATIONAHA.111.060061. Accessed 22 Sep 2015. PMID: 22891166
  54. Heidbuchel H, Verhamme P, Alings M, et al. Updated European Heart Rhythm Association practical guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace. 2015 Oct;17(10):1467-1507. doi: 10.1093/europace/euv309. Accessed 15 Jun 2016. PMID: 26324838
  55. Demaerschalk BM, Kleindorfer DO, Adeoye OM, et al; American Heart Association Stroke Council and Council on Epidemiology and Prevention. 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 Feb;47(2):581-641. doi: 10.1161/STR.0000000000000086. PMID: 26696642
  56. Dennis M, Caso V, Kappelle LJ, et al; for the European Stroke Organization. European Stroke Organization (ESO) guidelines for prophylaxis for venous thromboembolism in immobile patients with acute ischaemic stroke. Eur Stroke J. 2016 Mar;1(1):6-19. http://www.eso-stroke.org. Accessed 27 Jun 2016. PMID: 31008263
  57. Meschia JF, Bushnell C, Boden-Albala B, et al; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Functional Genomics and Translational Biology; Council on Hypertension. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014 Dec;45(12):3754-3832. http://stroke.ahajournals.org. Accessed 27 Jun 2016. PMID: 25355838
  58. Winstein CJ, Stein J, Arena R, et al; American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2016 Jun;47(6):e98-e169. doi: 10.1161/STR.0000000000000098. PMID: 27145936
  59. Xu AD, Wang YJ, Wang DZ; Chinese Stroke Therapy Expert Panel for Intravenous Recombinant Tissue Plasminogen Activator. Consensus statement on the use of intravenous recombinant tissue plasminogen activator to treat acute ischemic stroke by the Chinese Stroke Therapy Expert Panel. CNS Neurosci Ther. 2013 Aug;19(8):543-548. doi: 10.1111/cns.12126. Accessed 27 Jun 2016. PMID: 23710819
  60. The Stroke Society of the Philippines. SSP Handbook of Stroke: Guidelines for the Prevention, Treatment and Rehabilitation of Stroke. 6th ed. Quezon City, Philippines: The Stroke Society of the Philippines; 2014:11-121.
  61. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016 Oct;37(38):2893-2962. doi: 10.1093/eurheartj/ehw210. Accessed 27 Jan 2017. PMID: 27567408
  62. Smith EE, Saposnik G, Biessels GJ, et al; American Heart Association Stroke Council; Council on Cardiovascular Radiology and Intervention; Council on Functional Genomics and Translational Biology; and Council on Hypertension. Prevention of stroke in patients with silent cerebrovascular disease: a scientific statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2017 Feb;48(2):e44-e71. doi: 10.1161/STR.0000000000000116. Accessed 06 Apr 2017. PMID: 27980126
  63. Fugate JE, Rabinstein AA. Absolute and relative contraindications to IV rt-PA for acute ischemic stroke. Neurohospitalist. 2015 Jul;5(3):110-121. doi: 10.1177/1941874415578532. Accessed 05 May 2017. PMID: 26288669
  64. Minematsu K, Toyoda K, Hirano T, et al. Guidelines for the intravenous application of recombinant tissue-type plasminogen activator (alteplase), the second edition, October 2012: a guideline from the Japan Stroke Society. J Stroke Cerebrovasc Dis. 2013 Jul;22(5):571-600. doi: 10.1016/j.jstrokecerebrovasdis.2013.04.001. Accessed 05 May 2017. PMID: 23727456
  65. Pexman JH, Barber PA, Hill MD, et al. Use of the Alberta Stroke Program Early CT Score (ASPECTS) for assessing CT scans in patients with acute stroke. AJNR Am J Neuroradiol. 2001 Sep;22(8):1534-1542. http://www.ajnr.org. Accessed 05 May 2017. PMID: 11559501
  66. Saccor RL, Kasner SE, Broderick JP, et al. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013 Jul;44(7):2064-2089. doi: 10.1161/STR.0b013e318296aeca. Accessed 05 May 2017. PMID: 23652265
  67. Crocco TJ, Meurer WJ. Stroke. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018. Accessed 25 Jun 2018:1241-1255.
  68. Lau G, Pendlebury S, Rothwell P. The clinical features and differential diagnosis of acute stroke. Transient Ischemic Attack and Stroke: Diagnosis, Investigation and Treatment. Cambridge: Cambridge University Press; 2018. Accessed 02 Oct 2018:139-158.
  69. Marks MP, Heit JJ, Lansberg MG, et al. Endovascular treatment in the DEFUSE 3 study. Stroke. 2018 Jul 9;49:2000-2003. doi: 10.1161/STROKEAHA.118.022147. PMID: 29986935
  70. Baerlocher MO, Asch M, Myers A. Five things to know about metformin and intravenous contrast. CMAJ. 2013 Jan;185(1):E78. doi: 10.1503/cmaj.090550. Accessed 17 Jun 2019. PMID: 23048079
  71. Yee AH, Rabinstein AA. Neurologic presentations of acid-base imbalance, electrolyte abnormalities, and endocrine emergencies. Neurol Clin. 2010 Feb;28(1):1-16. doi: 10.1016/j.ncl.2009.09.002. PMID: 19932372
  72. Ortel TL. Chapter 42 - Antithrombotic therapy. In: McPherson RA, Pincus MR. Henry's Clinical Diagnosis and Management by Laboratory Methods. 23rd ed; 2017. http://dx.doi.org/10.1016/B978-0-323-29568-0.00042-5. Accessed 26 Jun 2018:842-853.e2.
  73. Powers WJ, Rabinstein AA, Ackerson T, et al; American Heart Association Stroke Council. 2018 Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2018 Mar;49(3):e46-e110. doi: 10.1161/STR.0000000000000158. Accessed 17 Apr 2018. PMID: 29367334
  74. 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 Dec;50(12):e344-e418. doi: 10.1161/STR.0000000000000211. Accessed 6 Mar 2020. PMID: 31662037
  75. Phipps MS, Cronin CA. Management of acute ischemic stroke. BMJ. 2020 Feb 13;368:l6983. doi: 10.1136/bmj.l6983. PMID: 32054610
  76. Hindricks G, Potpara T, Dagres N, et al; ESC Scientific Document Group. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021 Feb;42(5):373-498. doi: 10.1093/eurheartj/ehaa612. Accessed 18 May 2021. PMID: 32860505
  77. Malaysian Society of Neurosciences, Academy of Medicine Malaysia, Ministry of Health Malaysia, MSN Stroke Council. Clinical practice guidelines. Management of ischaemic stroke. 3rd edition. MOH (Malaysia). https://www.moh.gov.my. 2020. Accessed 09 Mar 2021.
  78. Adams HP Jr, Adams RJ, Brott T, et al. Guidelines for the early management of patients with ischemic stroke: a scientific statement from the Stroke Council of the American Stroke Association. Stroke. 2003 Apr;34(4):1056-1083. doi: 10.1161/01.STR.0000064841.47697.22. Accessed 16 Apr 2021
  79. Anderson D, Larson D, Sierzant T, et al. Institute for Clinical Systems Improvement. Diagnosis and initial treatment of ischemic stroke. ICSI. https://www.icsi.org. Jun 2019. Accessed 16 Apr 2021.
  80. Berge E, Whiteley W, Audebert H, et al. European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke. Eur Stroke J. 2021 Mar;6(1):I-LXII. doi: 10.1177/2396987321989865. Accessed 16 Apr 2021. PMID: 33817340
  81. Cucchiara BL, Messé SR. Antiplatelet therapy for the secondary prevention of ischemic stroke. UpToDate. https://www.uptodate.com. Accessed 16 Apr 2021.
  82. Diener HC, Weimar C, Weber R. Antiplatelet therapy in secondary stroke prevention – state of that art. J Cell Med. 2010 Nov;14(11):2552-2560. doi: 10.1111/j.1582-4934.2010.01163.x. Accessed 16 Apr 2021
  83. Family Practice Notebook. Ischemic stroke. Family Practice Notebook. https://www.fpnotebook.com/. Accessed 16 Apr 2021.
  84. Lip GYH, Banergee A, Boriani G, et al. Antithrombotic therapy for atrial fibrillation. CHEST Guideline and Expert Panel report. Chest. 2018 Nov;154(5):1121-1201. doi: 10.1016/j.chest.2018.07.040. Accessed 16 Apr 2021. PMID: 30144419
  85. Manning WJ, Singer DE, Lip GYH. Atrial fibrillation: anticoagulant therapy to prevent thromboembolism. UpToDate. https://www.uptodate.com. 27 Oct 2020.
  86. Ona DID, Jimeno CA, Jasul GV, et al. Executive summary of the 2020 clinical practice guidelines for the management of hypertension in the Philippines. J Clin Hypertens (Greenwich). 2021 Aug 3:1-14. doi: 10.1111/jch.14335. PMID: 34343391
  87. Visseren FLJ, Mach F, Smulders YM, et al; ESC National Cardiac Societies, ESC Scientific Document Group. 2021 ESC guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021 Sep 7;42(34):3227-3337. doi: 10.1093/eurheartj/ehab484. Accessed 15 Dec 2021. PMID: 34458905
  88. Beghi E, Binder H, Birle C, Bornstein N, et al. European Academy of Neurology and European Federation of Neurorehabilitation Societies guideline on pharmacological support in early motor rehabilitation after acute ischaemic stroke. Eur J Neurol. 2021 Sep;28(9):2831-2845. doi: 10.1111/ene.14936. PMID: 34152062
  89. Andre C, Bacellar AL, Bezerra DD, et al; Executive committee from the Brazilian Stroke Society and the Scientific Department in Cerebrovascular Diseases of the Brazilian Academy of Neurology. Guidelines for acute ischemic stroke treatment: part II: stroke treatment. Arq Neuropsiquiatr. 2012 Nov;70(11):885-893. doi: 10.1590/s0004-282x2012001100012. PMID: 23175203
  90. Campbell BCV, Ma H, Ringleb PA, et al; EXTEND, ECASS-4, and EPITHET Investigators. Extending thrombolysis to 4·5-9 h and wake-up stroke using perfusion imaging: a systematic review and meta-analysis of individual patient data. Lancet. 2019 Jul;394(10193):139-147. doi: 10.1016/S0140-6736(19)31053-0. PMID: 31128925
  91. Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 Guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association. Stroke. 2021 Jul;52(7):e364-e467. doi: 10.1161/STR.0000000000000375. Accessed 21 Jun 2022. PMID: 34024117
  92. Chen C, Li M, Lin L, et al. Clinical effects and safety of edaravone in treatment of acute ischaemic stroke: a meta-analysis of randomized controlled trials. Journal of Clinical Pharmacy and Therapeutics. 2021 Feb;46(4):907-917. https://doi.org/10.1111/jcpt.13392.
  93. Enomoto M, Endo A, Yatsushige H, et al. Clinical effects of early edaravone use in acute ischemic stroke patients treated by endovascular reperfusion therapy. Stroke. 2019 Mar;50(3):652-658. doi: 10.1161/STROKEAHA.118.023815. PMID: 30741623
  94. Kim JS. tPA helpers in the treatment of acute ischemic stroke: are they ready for clinical use?. JoS. 2019 May;21(2):160-174. https://doi.org/10.5853/jos.2019.00584.
  95. Kobayashi S, Fukuma S, Ikenoue T, et al. Effect of edaravone on neurological symptoms in real-world patients with acute ischemic stroke. Stroke. 2019 Jul;50(7):1805-1811. doi: 10.1161/STROKEAHA.118.024351. PMID: 31164072
  96. Shan H, Jiao G, Cheng X, et al. Safety and efficacy of edaravone for patients with acute stroke: a protocol for randomized clinical trial. Medicine. 2021 Feb;100(8):e24811. doi: 10.1097/MD.0000000000024811.
Editor's Recommendations
Special Reports
MORE Special Reports arrow
Related Disease News
MORE Disease News arrow