[Diagnosis and treatment in acute stroke]

Area of Science:

• Neurology
• Radiology
• Cardiovascular Medicine

Context:

• Transient ischemic attack (TIA) is recognized as a significant risk factor for subsequent stroke.
• Medical imaging technologies, particularly Magnetic Resonance Imaging (MRI), have advanced for diagnosing acute ischemic stroke.
• Tissue plasminogen activator (t-PA) therapy has been available in Japan since 1995 for stroke treatment.

Purpose:

• To highlight the evolving landscape of TIA and acute stroke diagnosis and management in Japan.
• To emphasize the importance of rapid etiological evaluation and treatment for TIA patients to prevent stroke.
• To discuss the role of advanced imaging and thrombolytic therapy in improving patient outcomes.

Summary:

• Recent advancements in Japan focus on immediate TIA evaluation and treatment due to high stroke risk.
• Improved medical equipment, including advanced MRI techniques (DWI, T(2)(*), FLAIR, MRA), enables accurate diagnosis of super acute ischemic stroke and its causes.
• Intravenous t-PA therapy, approved since 1995, facilitates early recanalization of occluded brain arteries, improving patient outcomes, though factors like lesion size and vessel signs can predict treatment response.

Impact:

• Enhanced diagnostic accuracy for acute ischemic stroke through advanced MRI techniques.
• Improved patient outcomes via timely intervention with t-PA therapy and specialized stroke unit care.
• Significant changes in acute stroke management strategies in Japan, emphasizing rapid response and multidisciplinary care.