Intensive Care Management of Acute Ischemic Stroke
Summary
Intensive care management of acute ischaemic stroke centres on rapid restoration of cerebral perfusion, diligent monitoring of neurological and systemic parameters, and mitigation of secondary injury. Initial interventions prioritise airway protection, controlled mechanical ventilation and haemodynamic optimisation to ensure adequate oxygen delivery to vulnerable penumbral tissue. Advanced neuromonitoring—including intracranial pressure measurement, transcranial Doppler ultrasonography and continuous electroencephalography—guides personalised titration of sedation and vasoactive agents. Thrombolytic therapy and endovascular thrombectomy have transformed early reperfusion strategies, yet they introduce risks of haemorrhagic transformation and oedema that demand vigilant intensive care surveillance. Prognostic models and emerging biomarkers inform clinical decision-making, aiding in the allocation of resources and setting realistic expectations for recovery. Multidisciplinary collaboration among neurologists, intensivists, nursing staff and rehabilitation specialists underpins a continuum of care, from acute stabilisation through ventilator weaning to functional rehabilitation. Ongoing research emphasises both technological innovation and pragmatic protocols that can be adapted across diverse healthcare settings to improve survival and neurological outcomes on a global scale.
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Intensive Care Management of Acute Ischemic Stroke publication trend
The graph below shows the total number of articles in intensive care management of acute ischemic stroke across all publications each year (not limited to Nature Index journals).
Technical terms
Glasgow Coma Scale (GCS): A clinical tool to assess consciousness level via eye opening, verbal response and motor response scores.
SOFA score: A composite assessment of organ dysfunction across respiratory, cardiovascular, hepatic, coagulation, renal and neurological systems.
Nomogram: A graphical representation combining multiple prognostic variables to estimate an individual patient’s probability of a clinical outcome.
Mechanical ventilation: A life-support technique employing a ventilator to assist or replace spontaneous breathing in critically ill patients.
Modified Rankin Scale (mRS): A six-point scale measuring residual disability or dependence in activities of daily living after stroke.
References
- Predicting 30-day mortality in intensive care unit patients with ischaemic stroke or intracerebral haemorrhage. European Journal of Anaesthesiology (2023).
- A novel higher performance nomogram based on explainable machine learning for predicting mortality risk in stroke patients within 30 days based on clinical features on the first day ICU admission. BMC Medical Informatics and Decision Making (2024).
- Effect of admission in the stroke care unit versus intensive care unit on in-hospital mortality in patients with acute ischemic stroke. BMC Neurology (2023).
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