The American Heart Association/American Stroke Association recently appointed a writing group to provide updated guidelines for the early management of acute ischemic stroke. The group was comprised of specialists in various areas of expertise, including neurology, neurosurgery, neurointerventional radiology, translational neuroscience, critical care, emergency medicine and nursing. This group of multidisciplinary experts reviewed randomized trials relevant to the treatment of ischemic stroke and developed new and updated guidelines.
José Biller, MD, chairperson of neurology at Loyola University Medical Center, was a contributing author of these updated guidelines for the treatment of adults with acute arterial ischemic stroke. He said,
The expectation is that the modern practice of medicine should be based on best evidence. The guidelines followed a meticulous methodology and are largely based on rigorous randomized trials."
Clinically, Dr. Biller cares for patients with aneurysms, brain hemorrhages and transient ischemic attacks in addition to caring for stroke patients. Loyola University Medical Center is recognized by the American Heart Association/American Stroke Association as a certified comprehensive stroke center. In addition to providing evidence-based stroke care to its own patients, Loyola provides telestroke services for hospitals across Illinois and neighboring states. "We emphasize 'time equals brain,' which is why the evaluation and treatment of acute stroke is time-sensitive. Through the use of technology, we can provide expertise on the diagnosis and management of strokes to our colleagues at other hospitals in real time," he said.
The updated guidelines apply to adult patients with ischemic stroke from the time symptoms appear to two weeks post-stroke. The guidelines have been made available to emergency medical services responders, physicians, allied health professionals and hospital administrators. Patients will benefit from major changes to treatment protocols, including updates to the use of aspirin and thrombolytic agents, the urgency of intervention with guidelines for prehospital triage and transport, as well as initiation of in-hospital measures to prevent recurrent stroke.
Stroke is a principal cause of mortality and disability. In the United States, stroke is the fifth leading cause of death, with more than 133,000 people dying because of stroke each year. At Loyola, said Dr. Biller, "we strive to practice evidence-based medicine and collaborate in the search for new knowledge. It is expected that within five to six years, the guidelines will be updated again because we will have new evidence."
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