• Franziska Herpich and Fred Rincon.
• Department of Neurology, Thomas Jefferson University Hospitals, Philadelphia, PA.
• Crit. Care Med. 2020 Nov 1; 48 (11): 1654-1663.

ObjectivesConcise "synthetic" review of the state of the art of management of acute ischemic stroke.Data SourcesAvailable literature on PubMed.Study SelectionWe selected landmark studies, recent clinical trials, observational studies, and professional guidelines on the management of stroke including the last 10 years.Data ExtractionEligible studies were identified and results leading to guideline recommendations were summarized.Data SynthesisStroke mortality has been declining over the past 6 decades, and as a result, stroke has fallen from the second to the fifth leading cause of death in the United States. This trend may follow recent advances in the management of stroke, which highlight the importance of early recognition and early revascularization. Recent studies have shown that early recognition, emergency interventional treatment of acute ischemic stroke, and treatment in dedicated stroke centers can significantly reduce stroke-related morbidity and mortality. However, stroke remains the second leading cause of death worldwide and the number one cause for acquired long-term disability, resulting in a global annual economic burden.ConclusionsAppropriate treatment of ischemic stroke is essential in the reduction of mortality and morbidity. Management of stroke involves a multidisciplinary approach that starts and extends beyond hospital admission.

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