Medicine and Health Sciences Commons^™

Acr Appropriateness Criteria® On Cerebrovascular Disease, Robert L. Delapaz, Franz J. Wippold Ii, Rebecca S. Cornelius, Sepideh Amin-Hanjani, Edgardo J. Angtuaco, Daniel F. Broderick, Douglas C. Brown, Jeffrey L. Creasy, Patricia C. Davis, Charles F. Garvin, Brian L. Hoh, Charles T. Mcconnell Jr, Laszlo L. Mechtler, David J. Seidenwurm, James G. Smirniotopoulos, Paul J. Tobben, Alan D. Waxman, Greg J. Zipfel

Uniformed Services University of the Health Sciences

Stroke is the sudden onset of focal neurologic symptoms due to ischemia or hemorrhage in the brain. Current FDA-approved clinical treatment of acute ischemic stroke involves the use of the intravenous thrombolytic agent recombinant tissue plasminogen activator given >3 hours after symptom onset, following the exclusion of intracerebral hemorrhage by a noncontrast CT scan. Advanced MRI, CT, and other techniques may confirm the stroke diagnosis and subtype, demonstrate lesion location, identify vascular occlusion, and guide other management decisions but, within the first 3 hours after ictus, should not delay or be used to withhold recombinant tissue plasminogen activator therapy after …