Acute Ischaemic Stroke Care in Developing Countries
Abstract
Stroke is a medical emergency and its management is a rapidly advancing field. New developments in pharmacologic and endovascular stroke therapy require thoughtful trial design and expeditious
trial implementation to assess clinical outcomes. We are marching from therapeutic nihilism to a proactive approach. This article discusses salient points in management of acute ischaemic stroke
relevant to developing countries.
References
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13. Marsh EB, Leigh R, Radvany M, Gailloud P, Llinas RH. Collaterals: an important determinant of prolonged ischemic penumbra versus rapid cerebral infarction? Front Neurol. 2014; 5:208.
14. Sanchetee P. Thrombolytic therapy in stroke. In BB Thakur (ed) Medicine Update – 10 (APICON- 2000), Associations of Physicians of India. 2000; 364-369.
15. Grotta JC. tPA for stroke: Important progress in achieving faster treatment. JAMA. 2014; 311:1615-1617.
16. Parsons M, Spratt N, Bivard A, et al. A randomized trial of tenecteplase versus alteplase for acute ischemic stroke. N Engl J Med. 2012;366:1099-1107.
17. Campbell BCV, Donnan GA, Davis SM. Vessel occlusion, penumbra, and reperfusion – translating theory to practice. Front Neurol. 2014; 5: 194.
18. Jovin TG, Chamorro A, Cobo E, et al for the REVASCAT Trial Investigators. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med. 2015; 372:2296-2306.
19. Berkhemer OA, Fransen PS, Beumer D et al. for MR CLEAN Investigators: A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015;372:11-20. Erratum in N Engl J Med. 2015;372:394.
20. Hennerici MG. Is there a new era for stroke therapy? Cerebrovasc Dis. 2015; 40:1-2.
21. Staley K. Stroke: Recovery inhibitors under attack. Nature. 2010; 468:176-177.
2. Norrving Bo, Brett Kissela B. The global burden of stroke and need for a continuum of care. Neurology. 2013; 80, Supplement 2:S5-S12.
3. Wouters A, Lemmens R, Dupont P, ThijsV. Wake-up stroke and stroke of unknown onset: a critical review. Front Neurol. 2014; 5:153.
4. Sanchetee P, Mathur A, Sanchetee S. Advances in acute stroke management. In A Banerjee (ed) API Text Book of Medicine, Associations of Physicians of India 2011; 21:221-228.
5. Ozturk S. Epidemiology and the global burden of stroke—Situation in Turkey. World Neurosurgery 2014; 81: e35-e36.
6. Pandian DJ, Padma V, Vijaya P, Sylaja PN, Murthy JMK. Stroke and thrombolysis in developing countries. Int J Stroke. 2007, 2:17–26.
7. Leira EC, Hess DC, Torner JC, Adams Jr HP. Ruralurban differences in acute stroke management practices. A modifiable disparity. Arch Neurol. 2008; 6:887-891.
8. Astrup J, Symon L, Branston NM, Lassen NA. Cortical evoked potential and extracellular K+ and H+ at critical levels of brain ischemia. Stroke. 1977;8:51–57.
9. Hillis AF, Baron JC. The ischemic penumbra: still the target for stroke therapies? Front Neurol. 2015; 6:85.
10. Muir KW, Buchan A, von Kummer R, Rother J, Baron JC. Imaging of acute stroke. Lancet Neurol. 2006; 5:755–768.
11. Kidwell CS, Alger JR, Saver JL. Beyond mismatch: evolving paradigms in imaging the ischemic penumbra with multimodal magnetic resonance imaging. Stroke. 2003; 34:2729–2735.
12. Agarwal S, Matys T, Marrapu ST, et al. Is CT-based perfusion and collateral imaging sensitive to time since stroke onset? Front Neurol. 2015;6:70.
13. Marsh EB, Leigh R, Radvany M, Gailloud P, Llinas RH. Collaterals: an important determinant of prolonged ischemic penumbra versus rapid cerebral infarction? Front Neurol. 2014; 5:208.
14. Sanchetee P. Thrombolytic therapy in stroke. In BB Thakur (ed) Medicine Update – 10 (APICON- 2000), Associations of Physicians of India. 2000; 364-369.
15. Grotta JC. tPA for stroke: Important progress in achieving faster treatment. JAMA. 2014; 311:1615-1617.
16. Parsons M, Spratt N, Bivard A, et al. A randomized trial of tenecteplase versus alteplase for acute ischemic stroke. N Engl J Med. 2012;366:1099-1107.
17. Campbell BCV, Donnan GA, Davis SM. Vessel occlusion, penumbra, and reperfusion – translating theory to practice. Front Neurol. 2014; 5: 194.
18. Jovin TG, Chamorro A, Cobo E, et al for the REVASCAT Trial Investigators. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med. 2015; 372:2296-2306.
19. Berkhemer OA, Fransen PS, Beumer D et al. for MR CLEAN Investigators: A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015;372:11-20. Erratum in N Engl J Med. 2015;372:394.
20. Hennerici MG. Is there a new era for stroke therapy? Cerebrovasc Dis. 2015; 40:1-2.
21. Staley K. Stroke: Recovery inhibitors under attack. Nature. 2010; 468:176-177.
Published
2019-08-10
How to Cite
Dr. Pratap Sanchetee. (2019). Acute Ischaemic Stroke Care in Developing Countries. The Indian Practitioner, 68(8), 66-74. Retrieved from https://articles.theindianpractitioner.com/index.php/tip/article/view/582
Section
Review article
