Treatment of Acute Brain Infarction

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  • Minematsu Kazuo
    Cerebrovascular Division, Department of Medicine, National Cardiovascular Center

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  • 脳梗塞の急性期治療

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Abstract

The management of acute brain infarction consists of emergency supportive care, treatment of medical and neurological complications (including brain edema, hemorrhagic transformation and brain herniation), and prevention of early recurrence. Acute management in a stroke care unit can reduce the short-term and long-term mortality, and may improve the functional outcome. The NINDS rt-PA Stroke Study Group recently demonstrated that treatment with intravenous t-PA within 3 hours of the onset of ischemic stroke improved clinical outcome at 3 months. Diffusion MRI enables demonstration not only of irreversibly damaged but also of penumibral brain tissues within minutes or hours after a stroke. Many neuroprotective agents, and hypothermia, are now under the clinical evaluation. To obtain the maxum benefits from these promising diagnostic and therapeutic tools, the education of the public and health-care workers will be needed. The establishment of emergency transfer centers and management systems will also be required.

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