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Critical care management in acute ischemic stroke
  1. Michael De Georgia,
  2. Vishal Patel
  1. University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
  1. Correspondence to Dr M A De Georgia, Neurological Institute, University Hospitals Case Medical Center, 11100 Euclid Avenue/Mail Stop HAN 5040, Cleveland, OH 44106-5040, USA; michael.degeorgia{at}


Neurocritical care has evolved over the past 20 years in parallel with the growth of critical care medicine and the stunning developments in the fields of neurology and neurosurgery. Although clinical trials are needed, there is preliminary evidence that induced hypertension and hypothermia can improve outcomes. The optimal threshold for transfusion of red cells remains unknown in patients with ischemic stroke and similarly further studies are needed to examine glycemic control and identify which patients may benefit most from aggressive insulin therapy. Finally, optimization of medical treatment is key in the care of the stroke patient and we should be cautious when prognosticating early in the setting of acute stroke and be aware of the potential effect ‘do not resuscitate’ status may have on patient outcome.

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  • Competing interests None.

  • Provenance and peer review Commissioned; not externally peer reviewed.