Treatment
ÎÎAspirin is NOT recommended as a substitute for other acute
interventions for treatment of stroke, including IV rtPA (III-B).
ÎÎThe administration of other IV antiplatelet agents that inhibit the
glycoprotein IIb/IIIa receptor is NOT recommended (III-B).
Note: Further research testing the usefulness of emergency administration of these
medications as a treatment option in patients with acute ischemic stroke is required.
ÎÎThe administration of aspirin (or other antiplatelet agents) as
an adjunctive therapy within 24 hours of IV fibrinolysis is NOT
recommended (III-C).
Volume Expansion, Vasodilators, and Induced Hypertension
ÎÎIn exceptional cases with systemic hypotension producing neurological
sequelae, a physician may prescribe vasopressors to improve cerebral
blood flow. If drug-induced hypertension is used, close neurological
and cardiac monitoring is recommended (I-C).
ÎÎThe administration of high-dose albumin is not well established as a
treatment for most patients with acute ischemic stroke until further
definitive evidence regarding efficacy becomes available (IIb-B).
ÎÎAt present, use of devices to augment cerebral blood flow for
the treatment of patients with acute ischemic stroke is not well
established (IIb-B).
Note: These devices should be used in the setting of clinical trials.
ÎÎThe usefulness of drug-induced hypertension in patients with acute
ischemic stroke is not well established (IIb-B).
INote: nduced hypertension should be performed in the setting of clinical trials.
ÎÎHemodilution by volume expansion is NOT recommended for
treatment of patients with acute ischemic stroke (III-A).
ÎÎThe administration of vasodilatory agents, such as pentoxifylline,
is NOT recommended for treatment of patients with acute ischemic
stroke (III-A).
Neuroprotective Agents
ÎÎAmong patients already taking statins at the time of onset of ischemic
stroke, continuation of statin therapy during the acute period is
reasonable (IIa-B).
ÎÎThe utility of induced hypothermia for the treatment of patients with
ischemic stroke is not well established (IIb-B).
Note: Further trials are recommended.
ÎÎAt present, transcranial near-infrared laser therapy is not well
established for the treatment of acute ischemic stroke (IIb-B).
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Note: Further trials are recommended.
