Neurocritical Care for Patients With Ischemic Stroke With Dr. T. M. Leslie-Mazwi
Jun 19, 2024
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Dr. T. M. Leslie-Mazwi discusses neurocritical care for ischemic stroke patients, covering topics such as the management of large vessel occlusion strokes, post-thrombectomy care challenges, advancements in neurocritical care, and proactive intervention strategies for better patient outcomes.
Timely evaluation and treatment are crucial in managing large vessel occlusions, requiring coordination among multiple care teams.
Expanding thrombectomy candidacy and refining patient selection criteria are key debates shaping the future of stroke treatment.
Deep dives
The Importance of Timely Evaluation and Care Team Coordination
In managing strokes due to large vessel occlusions, timely evaluation, triage, and treatment are crucial challenges. Coordination among multiple care teams, including EMS, endovascular teams, and rehabilitation teams, is essential. The neuro ICU plays a central role in organizing these teams and ensuring effective patient care.
Challenges in Management and Need for Further Research
One of the significant challenges in treating large vessel occlusion patients is the need for quick evaluation and treatment, highlighting systemic issues in healthcare delivery. Despite effective treatments like thrombectomy, a sizable proportion of patients still face challenging outcomes. Understanding and improving outcomes for this patient group remain a key challenge for future research.
Debates and Controversies in Thrombectomy Expansion
The expansion of thrombectomy candidacy beyond six hours post-symptom onset has sparked debates in the field. Ongoing discussions focus on treating distal occlusions, patients with well-maintained collaterals, and refining patient selection criteria. These debates shape the future direction of thrombectomy and involve neuro ICUs in crucial decision-making processes.
Management of stroke due to large vessel occlusion (LVO) has undergone unprecedented change in the past decade. Early identification and aggressive treatment are important in mitigating negative effects on patients’ prognoses.
In this episode, Allison Weathers, MD, FAAN, speaks with T. M. Leslie-Mazwi, MD, author of the article “Neurocritical Care for Patients With Ischemic Stroke,” in the Continuum June 2024 Neurocritical Care issue.
Dr. Weathers is a Continuum® Audio interviewer and an associate chief medical information officer at Cleveland Clinic in Cleveland, Ohio.
Dr. Leslie-Mazwi is a professor and chair in the department of neurology at the University of Washington in Seattle, Washington.