Contemporary treatment of patients with acute ischemic stroke include:
reperfusion strategies, basic treatment, secondary prevention and early
rehabilitation.
Reperfusion strategies involve removal or dissolution of thrombus which
caused cerebral vessel occlusion, and it should be performed in the first minutes /
hours after the onset of clinical signs of a stroke, and the reversible brain changes
could be assessed by neurovisualization methods.
Currently there are proposed several methods of reperfusion achieved
by systemic intravenous thrombolysis, selective intra-arterial thrombolysis,
mechanical thrombolysis and various combinations of these methods.
Intravenous rt-PA within the first 4.5 hours of acute ischemic stroke received
the highest level of evidence (Class 1, Level A) and is recommended for use in the
treatment of both acute ischemic stroke European guidelines, as well as from the
US.
The study included 40 patients with acute ischemic stroke treated by systemic
intravenous thrombolysis with rt-PA within the first 4.5 hours after the onset.
Neurovisualization was achieved by performing CTNC (computed tomography
non-contrast) and CTA (computed tomography angiography) at the onset, after 24
hours after thrombolytic therapy and CTNC after 30 days after the treatment . Were
appreciated the initial brain changes, cases of occlusion recanalization and types
of hemorrhagic transformation, when sings were present.