Key Points Endovascular therapy has become the main treatment for most ruptured and unruptured intracranial aneurysms. Various endovascular treatment modalities and devices with high safety and efficacy have been developed. Endovascular treatment has shown to be safer and comparably effective…
Key Points Large vessel occlusion (LVO) acute ischemic stroke (AIS) is a major cause of disability and mortality. Intravenous (IV) tissue plasminogen activator (tPA), approved nearly two decades ago for the treatment of AIS, has low rates of recanalization for…
Key Points The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) demonstrated higher risk of stroke with carotid angioplasty and stenting (CAS) and higher risk of myocardial infarction with carotid endarterectomy (CEA). Age, sex, lesion morphology, lesion location, and aortic arch…
Key Points A trial can be conducted only when there is equipoise. Phase 2 trials can reduce the number of ineffective treatments taken to phase 3 in stroke research. Common outcome measures are the National Institutes of Health stroke scale…
Key Points Cardioembolic stroke is a major etiology accounting for one-fifth of all ischemic strokes. Recent advances in technology have enabled us to monitor heart rhythm remotely and detect paroxysmal atrial fibrillation. Atrial cardiopathy is an area of further investigation…
Key Points Antiplatelet agents are the gold standard for secondary prevention of non-cardioembolic stroke. Aspirin, aspirin plus dipyridamole, or clopidogrel, ticagrelor, and possibly cilostazol are acceptable therapeutic alternatives. The combination of aspirin plus clopidogrel should not be used for long-term…
Key Points Over the past 15 years, cell therapies have attracted intense interest in their use as a potential treatment in a multitude of neurologic disorders including stroke. A large number of preclinical studies have provided important information on the…
Key Points Neural repair is a therapeutic strategy distinct from acute stroke strategies such as reperfusion: biologic targets are different. The goal is to boost function in surviving brain elements, not to salvage threatened tissue, and time windows are measured…
Key Points Neurologic rehabilitation is primarily concerned with lessening physical and cognitive impairments and functional disabilities, as well as returning patients to more normal participation in daily life. Rehabilitative strategies draw upon basic mechanisms of post-injury neural adaptations and learning…
Key Points Patients with intracerebral hemorrhage (ICH) should be cared for in specialized units with a focus on monitoring for deterioration and avoiding medical complications such as fever, hyper- or hypoglycemia, and deep vein thrombosis. Blood pressure lowering after ICH…