[Emergency treatment of acute cerebral ischemia]

EMERGENCY TREATMENT OF ACUTE CEREBRAL ISCHEMIA. Five complementary strategies increase disability - and dependency - free survival after acute cerebral ischemia: - stroke unit care, independent on age, severity, type of stroke, and treatment; - aspirin prevents 7 ischemic recurrences and 9 deaths or stroke recurrences during hospitalisation for 1000 patients treated; - rt-PA allows 1 additional disability-free survivor at 3 months for 3 patients treated within 90 minutes, 7 within 3 hours and 14 within 4.5 hours; tenecteplase can be used in most cases where intravenous thrombolysis is required; - mechanical thrombectomy improves the chances of dependency-free survival in patients with proximal arterial occlusion; this benefit persists between 6 and 24 hours in few patients selected multimodal imaging; - decompressive surgery reduces mortality and disability in patients under 60 years of age who have a large middle cerebral artery territory infarct within 48 hours.