About this Journal Submit a Manuscript Table of Contents
Stroke Research and Treatment
Volume 2013 (2013), Article ID 510481, 7 pages
http://dx.doi.org/10.1155/2013/510481
Review Article

Advances in the Critical Care Management of Ischemic Stroke

Department of Neurology, University of California-San Francisco, San Francisco General Hospital, 1001 Potrero Avenue, San Francisco, CA 94110, USA

Received 25 March 2013; Accepted 7 May 2013

Academic Editor: Majaz Moonis

Copyright © 2013 Vineeta Singh and Nancy J. Edwards. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Given recent advances in diagnostic modalities and revascularization capabilities, clinicians are not only able to rapidly and accurately identify acute ischemic stroke, but may also be able to aggressively intervene to minimize the extent of infarction. In those cases where revascularization cannot occur and/or the extent of infarction is large, there are multiple strategies to prevent secondary decompensation as the stroke evolves, for instance, if malignant cerebral edema should develop. In this paper, we will review the indications for specialized ICU care for an ischemic stroke patient, the treatment principles, and strategies employed by neurointensivists to minimize secondary neuronal injury, the literature in support of such strategies (and the questions to be addressed by future studies), all with the ultimate goal of increasing the likelihood of favorable neurologic outcomes in our ischemic stroke population.