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emergencyClinical Protocol
Time is Brain: Protocols for Acute Ischemic Stroke Management
A standardized operational guide for acute ischemic stroke intervention. This presentation covers the critical 'Time is Brain' philosophy, utilizing the NIH Stroke Scale to quantify deficits, localizing vascular territories including the MCA, ACA, and PCA. It provides clear inclusion and exclusion criteria for IV Thrombolysis using tPA or Tenecteplase, specific hemodynamic management protocols, guidelines for salvaging the penumbra via mechanical thrombectomy
Slides
15
Timeline
48 hours
Date
Mar 2026
Key Features
- ✓Clinical Triage: Outlines the binary decision-making process for Ischemic versus Hemorrhagic stroke and the importance of the Non-contrast CT gatekeeper.
- ✓Differential Diagnosis: Includes protocols for rapidly ruling out stroke mimics, such as hypoglycemia, Todd's Paralysis, and hemiplegic migraines.
- ✓Vascular Mapping: Provides detailed breakdowns of symptom localization for MCA, ACA, and PCA syndromes.
- ✓Intervention Timelines: Details strict time windows, including IV tPA eligibility within 4.5 hours and Mechanical Thrombectomy up to 24 hours from LKW.
- ✓Hemodynamic Control: Specifies target blood pressure management, requiring <185/110 mmHg for tPA candidates and utilizing permissive hypertension for non-tPA candidates.
- ✓Secondary Prevention: Summarizes long-term management strategies, including antiplatelets, high-intensity statins, anticoagulation for AFib, and surgical management for carotid stenosis.
Full Presentation
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