Management of Mild Ischemic Stroke

Mild ischemic stroke, typically defined by a National Institutes of Health Stroke Scale score of ≤ 5, accounts for a substantial proportion of acute cerebrovascular presentations. Early identification and risk stratification are essential, combining detailed neurological assessment with multimodal imaging—such as CT angiography and diffusion-weighted MRI—to detect large vessel occlusion and ischaemic penumbra. Intravenous thrombolysis within 4.5 hours of symptom onset can improve functional outcomes, while selected patients with persistent deficits and confirmed arterial occlusion may benefit from endovascular thrombectomy. Secondary prevention comprises antithrombotic therapy tailored to stroke subtype, aggressive control of blood pressure, lipids and glycaemia, and lifestyle modification. A multidisciplinary approach, integrating early rehabilitation and patient education, underpins long-term recovery and reduces recurrent events. Emerging risk models and biomarkers promise to refine individualised treatment decisions and optimise resource allocation on a global scale.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Management of Mild Ischemic Stroke publication trend

The graph below shows the total number of articles in management of mild ischemic stroke across all publications each year (not limited to Nature Index journals).

Technical terms

National Institutes of Health Stroke Scale (NIHSS): A structured assessment tool that quantifies stroke severity on a scale from 0 (no deficit) to 42 (severe impairment).

Intravenous thrombolysis: Administration of fibrinolytic medication, typically recombinant tissue plasminogen activator, through a peripheral vein to dissolve intracerebral thrombi.

Endovascular thrombectomy: A minimally invasive, catheter-based procedure to mechanically remove occlusive clots from major cerebral arteries.

Large vessel occlusion (LVO): An arterial blockage affecting major intracranial vessels—such as the internal carotid or proximal middle cerebral arteries—identified via angiographic imaging.

References

1. Intravenous thrombolysis versus antiplatelet therapy in minor stroke patients with large vessel occlusion. CNS Neuroscience & Therapeutics (2023).
2. Reperfusion therapy for minor stroke: A systematic review and meta‐analysis. Brain and Behavior (2019).
3. Efficacy and safety of endovascular thrombectomy in mild ischemic stroke: results from a retrospective study and meta-analysis of previous trials. BMC Neurology (2019).