Management of Acute Ischemic Stroke

The management of acute ischemic stroke (AIS) necessitates a collaborative approach, with critical care specialists playing a pivotal role. Historically, treatment options were focusing on symptomatic relief, secondary prevention, and rehabilitation. Nowadays, stroke teams, comprising various medical professionals, offer comprehensive care round-the-clock. Telemedicine aids in swift and accurate diagnosis of stroke syndromes. In the era of recanalization for AIS with large vessel occlusion (LVO), telemedicine systems facilitate the identification of patients requiring endovascular therapies, leading to improved functional outcomes and quality of life.
Advanced stroke management prioritizes revascularization and limiting secondary neuronal injury, with intravenous thrombolysis and endovascular therapy available for selected patients. Supplemental oxygen may be necessary for patients with oxygen saturation below 94%. Failure to recognize impending airway loss can lead to complications such as aspiration and hypoxemia, emphasizing the need for prompt airway management. Hyperbaric oxygen therapy's efficacy remains uncertain in AIS patients. Persistent in-hospital hyperglycemia post-AIS is linked to poorer outcomes, underscoring the importance of glycemic control. Early mobilization is advocated to optimize functional recovery post-stroke. This multidisciplinary approach, supported by telemedicine advancements, enhances stroke care outcomes, promoting better patient outcomes and quality of life.