RECENT ADVANCES IN ACUTE BRAIN STROKE MANAGEMENT

RECENT ADVANCES IN ACUTE BRAIN STROKE MANAGEMENT

According to WHO, 15 million people suffer a stroke worldwide annually. Of those, 1/3rd do not survive, and another third is left with significant neurological deficits. The majority of these events come under the category of ischemic strokes (87%).

Acute ischemic stroke is a medical emergency characterized by the sudden blockage of blood flow to the brain, resulting in neurological deficits. Rapid and appropriate management is crucial to minimize brain damage and improve patient outcomes.

Early recognition of stroke symptoms is key to maximising the potential for medical intervention and more favourable stroke outcomes - the ‘time is brain’ imperative.

Remember pneumonic- BE-FAST (Balance(Loss of Balance)/Eye Vision (Deminished Vision) /Face (Facial Droop) /Arm Drift / Speech (Difficulty in Speaking) / Time (Time is Brain)) to Identifying stroke symptoms faster. Healthcare professionals should be trained to recognize stroke symptoms promptly and activate the stroke team. The use of validated stroke scales, such as the National Institutes of Health Stroke Scale (NIHSS), helps assess stroke severity and guide treatment decisions.

Reperfusion therapy aims to restore blood flow to the ischemic brain tissue and salvage viable neurons. The two main strategies for reperfusion include intravenous thrombolysis with tissue plasminogen activator(tPA) and endovascular thrombectomy.

Intravenous Thrombolysis Administering tPA within the first few hours (4.5 hrs window) of symptom onset can improve outcomes. However, eligibility criteria and time windows for thrombolysis should be strictly followed to minimize the risk of complications.

Endovascular Thrombectomy Involves the mechanical removal of the clot using specialized devices. Endovascular thrombectomy has shown signifi-cant benefits in selected patients with large vessel occlusions. This article provides an overview of the current approaches and strategies for the management of acute ischemic stroke.