[Stroke therapy. What is established, what is new?].

Area of Science:

• Neurology
• Emergency Medicine
• Critical Care

Background:

• Stroke is a leading cause of death and disability.
• Prompt medical intervention is crucial for improving patient outcomes.
• Optimizing physiological parameters is essential in acute stroke management.

Purpose of the Study:

• To outline critical early management strategies for stroke patients.
• To highlight interventions that improve neurological deficits and survival.
• To discuss current and future therapeutic options in stroke care.

Main Methods:

• Review of established and emerging stroke treatment protocols.
• Emphasis on physiological support: oxygenation, temperature, and glycemic control.
• Discussion of pharmacological (antithrombotics, blood pressure management) and non-pharmacological (physiotherapy, logopedics) interventions.

Main Results:

• Optimal oxygen supply, fever reduction, and normal blood sugar levels improve prognosis.
• Moderate blood pressure lowering is recommended only for very high pressures; raising blood pressure may benefit cerebral blood flow.
• Antithrombotic measures and early rehabilitation are vital for specific patient groups.

Conclusions:

• Early and comprehensive stroke unit care significantly reduces neurological deficits and improves survival.
• Multifaceted management including physiological optimization, targeted therapies, and rehabilitation is key.
• Advanced therapies like thrombolysis require specialized centers, while plasma substitutes and hemodilution show future promise.