Acute Ischaemic Stroke
Time is brain!
Acute ischaemic stroke is a medical emergency. It is essential that the general public recognise the need for emergency treatment, and that emergency services and all healthcare professionals who see patients with stroke symptoms act accordingly.
Every minute that the blood supply to the brain is interrupted, approximately 1.9 million neurons are lost.1 Loss of brain tissue is associated with loss of brain function and corresponding disability, or potentially even death. The earlier that adequate treatment can be started and blood flow to the brain is restored, the better the outcome will be for the patient.2
Find out more information on the importance of time and other resources on acute ischaemic stroke.
Timely treatment
Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA, alteplase) can be used in eligible patients with an acute ischaemic stroke if administered within 4.5 hours of symptom onset, as stated in international stroke guidelines.3,4
The use of rt-PA in thrombolysis of acute ischaemic stroke has been investigated in major clinical study programmes and registries. These include the Safe Implementation of Treatments in Stroke (SITS), the European Cooperative Acute Stroke Study (ECASS) and the Virtual International Stroke Trials Archive (VISTA). Visit Stroke Forum for details of these programmes and their results.
Following intravenous thrombolysis, certain patients may meet specific selection criteria for further endovascular procedures. Time is once again an extremely important factor when considering clinical outcomes.5
Find out more information on endovascular stroke trials.
Organised stroke care
Urgent assessment and specialised stroke care is essential to ensure that patients have optimal recoveries. Lack of awareness, organisation and poor infrastructure can present unnecessary obstacles and delays in stroke treatment. Especially in rural areas, where hospital access may be difficult, this can be quite a challenge.
International stroke guidelines recommend stroke unit care as the gold standard for stroke patient management, as it results in the best outcomes in terms of death and disability measures.3,4 The work of a stroke unit can be optimised further with the support of an accompanying organised stroke network, focused on ensuring that the stroke patient receives the best possible treatment within the shortest time period.
Organised stroke networks may include services such as telestroke, which aims to overcome geographical barriers by helping less experienced physicians receive expert guidance regarding the treatment of their stroke patient.
Visit our website Stroke Forum for more information about organised stroke care.
Hear from the experts
View the webcasts of David Hargroves and Kennedy Lees speaking about the benefits of organised stroke care at the 1st European Stroke Organisation Conference (ESOC) 2015 in Glasgow, Scotland, during the Boehringer Ingelheim sponsored satellite symposium, entitled “Tailoring acute stroke thrombolysis to person, time and place: Are we ready?”
Angels Initiative
The angels initiative is a unique programme being brought to life by Boehringer Ingelheim across the world. The aim of the angels initiative is to improve acute ischaemic stroke care. The programme provides doctors and hospitals with the necessary tools, resources and support they need to set up and optimise acute stroke networks worldwide.
If you are interested in this for your hospital and you are from an eligible country, visit the angels initiative website to gain free access to all angels materials as well as further supportive benefits. All the materials have been developed together with our expert steering committee.
Find out more
For more information on research and treatment for acute ischaemic stroke, please visit our website Stroke Forum.
References
- Saver J. Time is Brain – Quantified. Stroke 2006;37:263-266.
- Lees K, et al. Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials. Lancet 2010;375:1695-1703.
- Jauch E, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke. Stroke 2013;44:870-947.
- ESO Guidelines 2009 Update. www.eso-stroke.org
- Powers W, et al. 2015 AHA/ASA Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment. Stroke 2015;46:DOI: 10.1161/STR.0000000000000074 (Published online before print.)