ACUTE ISCHEMIC STROKE

Transcription

1 ACUTE ISCHEMIC STROKE

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3 ACUTE ISCHEMIC STROKE An Evidence-based Approach EDITED BY DAVID M. GREER WILEY-LISS A JOHN WILEY & SONS, INC., PUBLICATION

4 Copyright ß 2007 by John Wiley & Sons, Inc. All rights reserved. Published by John Wiley & Sons, Inc., Hoboken, New Jersey Published simultaneously in Canada No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, , fax , or on the web at Requests to the Publisher for permission should be addressed to teh Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, , fax , or online at Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor author shall be liable for any loss of profit or any other commerical damages, including but not limited to special, incidental, consequential, or other damages. For general information on our other products and services or for technical support, please contact our Customer Care Department within the United States at , outside the United States at or fax Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic formats. For more information about Wiley products, visit our web site at Wiley Bicentennial Logo: Richard J. Pacifico Library of Congress Cataloging-in-Publication Data: Acute ischemic stroke : an evidence-based approach / [edited by] David M. Greer. p. ; cm. Includes bibliographical references. ISBN (cloth) 1. Cerebrovascular disease Treatment. 2. Cerebral ischemia Treatment. 3. Evidence-based medicine. I. Greer, David M., [DNLM: 1. Cerebrovascular Accident therapy. 2. Evidence-Based Medicine. WL 355 A ] RC388.5.A dc Printed in the United States of America

5 CONTENTS Preface Contributors vii ix 1. Stroke: Historical Perspectives and Future Directions 1 Magdy Selim, MD, PhD 2. Neuroimaging of the Acute Stroke Patient 3 William A. Copen, MD, and Michael H. Lev, MD 3. Intravenous Thrombolysis 39 Sherry H.-Y. Chou, MD, and Eric E. Smith, MD, MPH, FRCPC 4. Endovascular Approaches to Acute Stroke 63 Raul G. Nogueira, MD, Guilherme C. Dabus, MD, Joshua A. Hirsch, MD, and Lee H. Schwamm, MD 5. Nonthrombolytic Acute Stroke Therapies 97 Aneesh B. Singhal, MD, Larami MacKenzie, MD, and Joshua M. Levine, MD 6. Surgical Management of Acute Stroke Patients 123 Alim P. Mitha, MD, Carlos E. Sanchez, MD, and Christopher S. Ogilvy, MD 7. Antithrombotic Therapy for Acute Stroke 137 Orla Sheehan, MD, BAO, BCh, MRCPI, and Peter Kelly, MD, MS, FRCPI v

6 vi CONTENTS 8. Intensive Care Management of Acute Ischemic Stroke 163 Kevin N. Sheth, MD, and David M. Greer, MD, MA 9. Evaluation of Acute Stroke Etiologies 197 Karen L. Furie, MD, MPH, Michael H. Lev, MD, Walter J. Koroshetz, MD, and David M. Greer, MD, MA 10. TeleStroke: Application of Telemedicine in Acute Ischemic Stroke 213 Eric S. Rosenthal, MD, and Lee H. Schwamm, MD Index 233

7 PREFACE For many years, physicians have been plagued by a paucity of available treatments for patients with acute ischemic stroke. The therapies we had to offer were either potentially quite hazardous, sometimes leading to poor outcomes, or so benign as to seem to offer little benefit. However, with advances in our understanding of stroke mechanisms, different patient populations, timing of therapy, and modern medicines and techniques, we have gained the ability to successfully treat acute ischemic stroke in a manner that has proven beneficial over broad categories of patients. We now have the opportunity to make our treatment of acute stroke evidence based we can be guided by many large randomized trials looking at thrombolytic agents, antithrombotic agents, and neuroprotective agents. The evidence has taken us a great distance, but has sometimes raised more questions than it has answered. This book provides the reader with an excellent review of the evidence to support the current treatment of acute ischemic stroke and provides an avenue for discovery by highlighting the future directions of research. I am greatly indebted to the authors of this book, who have painstakingly waded through the data to provide a comprehensive and thorough evaluation of the literature. We hope that you will find herein a guide to support your practice and research interests, and perhaps a clue to how we might together further the field of acute stroke treatment. DAVID M. GREER, MD, MA vii

8 CONTRIBUTORS Alim P. Mitha, MD Massachusetts General Hospital Aneesh B. Singhal, MD Massachusetts General Hospital Carlos E. Sanchez, MD Massachusetts General Hospital Christopher S. Ogilvy, MD Massachusetts General Hospital David M. Greer, MD, MA Massachusetts General Hospital Eric E. Smith, MD, MPH, FRCPC Massachusetts General Hospital Eric S. Rosenthal, MD Massachusetts General Hospital Guilherme C. Dabus, MD Massachusetts General Hospital Joshua A. Hirsch, MD Massachusetts General Hospital Joshua M. Levine, MD Hospital of the University of Pennsylvania Karen L. Furie, MD, MPH Massachusetts General Hospital Kevin N. Sheth, MD Massachusetts General Hospital Larami MacKenzie, MD Hospital of the University of Pennsylvania Lee H. Schwamm, MD Massachusetts General Hospital Magdy Selim, MD, PhD Beth Israel Hospital, Boston Michael H. Lev, MD Massachusetts General Hospital ix

9 x CONTRIBUTORS Orla Sheehan, MD, BAO, BCh, MRCPI Mater University Hospital and University College, Dublin, Ireland Peter Kelly, MD, MS, FRCPI Mater University Hospital and University College, Dublin, Ireland Raul G. Nogueira, MD Massachusetts General Hospital Sherry H.-Y. Chou, MD Massachusetts General Hospital Walter J. Koroshetz, MD National Institute of Health, National Institute of Neurologic Disorders and Stroke William A. Copen, MD Massachusetts General Hospital