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Chapter 11 - Ischemic Stroke in the Neurocritical Care Unit

Published online by Cambridge University Press:  24 July 2019

By
Julian Bösel
Edited by
Michel T. Torbey
Michel T. Torbey
Affiliation:
Ohio State University
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Summary

Severe acute ischemic stroke (AIS) has been recognized as deserving management in the neurocritical care unit (NCCU) and considerable progress in its understanding and management has been made over the last 10 years. The results of older studies had put into question the usefulness of giving patients with severe AIS access to NCCU treatment and mechanical ventilation, based on a very poor reported prognosis with mortality rates between 50 and 80% [1–4]. Today, however, treatment options such as endovascular thrombectomy, decompressive surgery, or targeted temperature management have changed the perspective of these patients, and they require rapid, adequately aggressive, and consequent emergency and critical care. This chapter addresses, in fairly chronological order, the step-wise management of severe ischemic stroke, i.e. the acute assessment, stabilization, and recanalizing treatment in the emergency room (ER), the general aspects of care for ischemic stroke patients in the NCCU, and finally specific treatment aspects associated with different types of ischemic stroke. Other features of stroke care, such as recognition and prehospital management, general stroke unit management, and secondary stroke prophylaxis, will not be covered.

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Neurocritical Care , pp. 103 - 128
Publisher: Cambridge University Press
Print publication year: 2019

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