Dr Sohil Pothiawala
Woodlands Health Campus
Department of Emergency Medicine
Advances in Stroke management
The primary aim to streamline care of Hyperacute Ischemic Stroke patients in the ED is timely reperfusion, using either intravenous thrombolysis within 4.5 hours of symptom onset and/or endovascular therapy with mechanical thrombectomy within 6 hours in patients with large artery occlusion on CT Angiogram. Emerging evidence recommends expansion of the time window for reperfusion therapy in patients with wake-up stroke, even up to 24 hours in selected patients. Identification of patients who may benefit from this extended time window reperfusion therapy depends on their careful selection using MRI/perfusion brain imaging and determining the status of collateral circulation.