Evolving Treatments for Acute Ischemic Stroke

You will have to send your doctor after this to see if any protocols are proposed for the hyperacute period. See if they are treating any of the 5 causes of the neuronal cascade of death? Do they mention any of the 1000+ failed neuroprotective research trials that Dr. Michael Tymianski, of the Toronto Western Hospital Research Institute in Canada  talks about? Anything on my 31 ideas on hyperacute therapy I'm going to insist my doctor give me during the first week?
Which of these 177 hyperacute therapies that need more research did they study?
Did anything here advance knowledge in helping survivors recover?
I bet nothing useful comes from this, your doctor can email them asking what they did to advance the stroke strategy.
http://circres.ahajournals.org/content/118/9/1425.abstract?etoc 

1. Charlotte Zerna*,
2. Janka Hegedus*,
3. Michael D. Hill†

+ Author Affiliations

1. From the Calgary Stroke Program, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.

1. Correspondence to Michael D. Hill, MD, MSc, Calgary Stroke Program, Department Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Health Sciences Centre, 3300 Hospital Dr NW Calgary, AB T2N 4N1, Canada. E-mail michael.hill@ucalgary.ca

1. ↵* Drs Zerna and Hegedus jointly wrote and are considered co-first authors of this article.
2. ↵† Dr Hill provided oversight and senior authorship.

Abstract

The purpose of this article is to review advances in stroke treatment in the hyperacute period. With recent evolutions of technology in the fields of imaging, thrombectomy devices, and emergency room workflow management, as well as improvement in statistical methods and study design, there have been ground breaking changes in the treatment of acute ischemic stroke. We describe how stroke presents as a clinical syndrome and how imaging as the most important biomarker will help differentiate between stroke subtypes and treatment eligibility. The evolution of hyperacute treatment has led to the current standard of care: intravenous thrombolysis with tissue-type plasminogen activator and endovascular treatment for proximal vessel occlusion in the anterior cerebral circulation. All patients with acute ischemic stroke are in need of hyperacute secondary prevention because the risk of recurrence is highest closest to the index event. The dominant themes of modern stroke care are the use of neurovascular imaging and speed of diagnosis and treatment.