Ischemic Brain Vascular Accident: Acute Phase Management

Abstract

To address, in a practical way, the acute treatment of ischemic cerebrovascular accident (CVA) based on the scientific recommendations latest. Methods: A bibliographic search was performed in the PubMed, Scopus, Scielo and Uptodate database from January/2012 to April/2018, using the descriptors "stroke", "early management", "therapeutic", "intravenous thrombolysis", "combined treatment", "mechanical thrombectomy" and its combinations. The selection of the articles was made by listing those of greater relevance according to the proposed theme, both in the foreign and Brazilian literature, in a nonsystematic way. Results: Intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) within 4.5 hours of onset of symptoms is considered the therapy of choice in eligible patients. According to the new guidelines, mechanical thrombectomy can be performed within 24h and, for prevention of subsequent ischemic events, revascularization between 48h and seven days of the index event in candidate patients is reasonable. Conclusions: As an essential cause of death and disability in the world, acute ischemic stroke treatment has advanced rapidly in recent years, improving therapeutic methods and their combinations. In clinical practice, recognizing, stratifying and listing, quickly and effectively, the best therapy for stroke patients is paramount.