The Management of Acute Ischaemic Stroke – A Review and South African Perspective

Eitzaz Sadiq, Louis Kroon, Naeem Brey, Andre Mochan
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引用次数: 0

Abstract

Abstract Reperfusion therapy in acute ischaemic stroke, namely intravenous thrombolysis and mechanical thrombectomy, have traditionally had strict time-based eligibility criteria. Recent advances in diagnostic and imaging modalities have resulted in a more dynamic view of eligibility for these therapies. The time clock concept may soon be superseded by the “tissue clock” concept, where accurate identification of the extent of the salvageable penumbra has been shown to result in favourable outcomes well beyond the traditional time limits in carefully selected patients. However in a low-middle income country like South Africa, the social, economic and geographic barriers to an effective acute stroke management service are often overwhelming. In this review we provide an update on the current evidence guiding management of acute ischaemic stroke, with a particular emphasis on the challenges faced in resource-constrained regions.
急性缺血性脑卒中的管理-回顾和南非的观点
急性缺血性脑卒中再灌注治疗,即静脉溶栓和机械取栓,传统上有严格的基于时间的资格标准。在诊断和成像模式的最新进展导致了这些治疗的资格更动态的看法。时间时钟的概念可能很快被“组织时钟”的概念所取代,在“组织时钟”的概念中,准确识别可修复的半影的范围已被证明可以在精心挑选的患者中远远超出传统的时间限制而产生有利的结果。然而,在像南非这样的中低收入国家,提供有效的急性中风管理服务的社会、经济和地理障碍往往是压倒性的。在这篇综述中,我们提供了指导急性缺血性卒中管理的最新证据,特别强调了资源受限地区面临的挑战。
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CiteScore
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