The American Heart Association/American Stroke Association has updated their comprehensive acute stroke care guidelines from 2009. While we therapists are usually not involved in treating stroke patients at this stage, hopefully we will now see fewer patients with long term sequelae. There is clearly a greater “push” for thrombolysis with TPA, and they have extended the window of time to a 4.5 hour window (from 3 hours) in certain cases. Contraindications are also revamped. They are recommending teleradiology for community hospitals that lack access to neurological expertise. Mechanical thrombectomy in acute stroke has not been shown to improve patient outcomes.
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