University of Iowa News Release
Release: April 4, 2003
UI Neurology Professor Leads Update Of Urgent Stroke Care Guidelines
A neurologist at University of Iowa Hospitals and Clinics led the effort to update the guidelines for treating patients affected by ischemic strokes. The updated guidelines from the American Stroke Association are published in today's issue of Stroke: Journal of the American Heart Association.
The "Guidelines for the Early Management of Patients' Ischemic Stroke" is a revision of statements and supplements written in 1994 and 1996. The statement, aimed at primary care physicians, emergency medicine physicians, neurologists and others who provide acute stroke care upon hospital admission through the first 48 hours, discusses how to manage the neurological and medical problems that can complicate patient recovery.
Stroke is the third leading cause of death in the United States and the leading cause of disability. Ischemic strokes, the most common type of stroke, are caused by a blood clot blocking blood flow to the brain. Giving tissue plasminogen activator (tPA) within three hours of stroke onset is the only U.S. Food and Drug Administration-approved treatment for ischemic stroke.
"It was time to review the state of acute stroke care. Considerable research in stroke has been done in the last decade, and the guidelines for physicians need to reflect the new information," said Harold P. Adams, Jr., M.D., chair of the panel that authored the guidelines and professor of neurology in the UI Roy J. and Lucille A. Carver College of Medicine.
Some of the recent research has investigated neuroprotective agents to prevent stroke damage, methods to induce hypothermia to reduce fever and prevent stroke damage, other clot busting drugs and techniques, imaging techniques to diagnose ischemic stroke, and surgical interventions.
While the advances are considerable, noted Adams, "much additional work needs to be done. In this statement, we re-emphasize the potential use of rtPA for emergency intravenous management of carefully selected patients who could be treated within three hours of ischemic stroke."
Among their recommendations, the panel notes:
"In the previous guidelines, we concluded that the data were insufficient to make any recommendation about the use of anticoagulants," Adams said. "Since then, several trials have tested the potential use of anticoagulants for early treatment of patients with stroke - and with negative results."
Other authors include Robert J. Adams, M.D.; Thomas Brott, M.D.; Gregory J. del Zoppo, M.D.; Anthony Furlan, M.D.; Larry B. Goldstein, M.D.; Robert L. Grubb, M.D.; Randall Higashida, M.D.; Chelsea Kidwell, M.D.; Thomas G. Kwiatkowski, M.D.; John R. Marler, M.D.; and George J. Hademenos, Ph.D.
For more information on stroke, visit the American Stroke Association Web site: www.strokeassociation.org.
University of Iowa Health Care describes the partnership between the UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide. Visit UI Health Care online at www.uihealthcare.com.
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