Acute and Subacute Ischemic Stroke A Review of Temperature, Blood Pressure and Glycemic Management
T he treatment of ischemic stroke is often divided between acute interventions (endovascular therapy, intravenous tissue plasminogen activator [IV tPA] and long term secondary prevention (modifying risk factors, antithrombotic therapy, etc. There is great variability between practitioners in the medical management of stroke during hospitalization, in part because of confusing and contradictory results in the literature. Temperature management and therapeutic hypothermia is discussed in this review. In regards to blood pressure targets, while permissive hypertension is often recognized as a beneficial strategy in acute stroke, blood pressure reduction is essential for secondary stroke prevention. We review the literature regarding optimal timing of different blood pressure goals. Finally, the limited literature regarding glycemic control in ischemic stroke patients is discussed.