Flowchart for the diagnosis and treatment of severe ischaemic stroke_West China Medical Journal

Authors：

WU Simiao ¹ , WU Bo ¹ , GUO Fuqiang ² , ZHANG Shihong ¹ , HAO Zilong ¹ , YANG Dongdong ³ , LI Xiaogang ⁴ , WU Bihua ⁵ , WANG Chun ⁶ , DUAN Jingfeng ⁷ , LING Tianjin ⁸ , ZHANG Hao ⁹ ,  LIU Ming ¹ , on behalf of Severe Ischaemic Stroke Collaboration

1. Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan 610072, P. R. China;
3. Department of Neurology, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, P. R. China;
4. Department of Neurology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P. R. China;
5. Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 634700, P. R. China;
6. Department of Neurology, People’s Hospital of Deyang City, Deyang, Sichuan 618000, P. R. China;
7. Department of Neurology, Mianyang Central Hospital, Mianyang, Sichuan 621000, P. R. China;
8. Department of Neurology, the First People’s Hospital of Ziyang, Ziyang, Sichuan 641300, P. R. China;
9. Department of Neurology, Jiangyou People’s Hospital, Jiangyou, Sichuan 621000, P. R. China;

Corresponding?author：

LIU Ming, Email: wyplmh@hotmail.com

Keywords：

Ischaemic stroke; Severe; Massive; Diagnosis and treatment; Flowchart

DOI：

10.7507/1002-0179.201909161

Video：

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Abstract Full text Figures/Tables Video References Cited by

Severe/massive ischaemic stroke is difficult to treat and has poor prognosis. There are limited studies for specific treatment of these conditions and no consensus on their definitions. This proposal suggests definitions and a flowchart for the diagnosis and treatment of these conditions. We focus on predicting and preventing malignant oedema at an early stage, monitoring the level of consciousness and vital signs, and the prevention and management of complications (eg. pulmonary infections). We particularly provide suggestions for the treatment with intravenous thrombolysis, endovascular treatment, antiplatelet and anticoagulation. More studies are warranted to support individualised management of infarct swelling, intracranial hypertension and early rehabilitation for severe/massive ischaemic stroke.

Citation： WU Simiao, WU Bo, GUO Fuqiang, ZHANG Shihong, HAO Zilong, YANG Dongdong, LI Xiaogang, WU Bihua, WANG Chun, DUAN Jingfeng, LING Tianjin, ZHANG Hao, LIU Ming, on behalf of Severe Ischaemic Stroke Collaboration. Flowchart for the diagnosis and treatment of severe ischaemic stroke. West China Medical Journal, 2019, 34(10): 1096-1108. doi: 10.7507/1002-0179.201909161 Copy

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