REVIEWARTICLE Imaging and Treatment of Patients with Acute Stroke: An Evidence-Based Review

SUMMARY: Evidence-based medicine has emerged as a valuable tool to guide clinical decision-making, by summarizing the best possible evidence for both diagnostic and treatment strategies. Imaging plays a critical role in the evaluation and treatment of patients with acute ischemic stroke, especially those who are being considered for thrombolytic or endovascular therapy. Time from stroke-symptom onset to treatment is a strong predictor of long-term functional outcome after stroke. Therefore, imaging and treatment decisions must occur rapidly in this setting, while minimizing unnecessary delays in treatment. The aim of this review was to summarize the best available evidence for the diagnostic and therapeutic management of patients with acute ischemic stroke. ABBREVIATIONS: DPM diffusion-perfusion mismatch; IA intra-arterial; ICH intracranial hemorrhage; r-proUK recombinant prourokinase; TIMI Thrombolysis in Myocardial Infarction In this era of health care reform and cost containment, major con-cerns have been raised regarding inappropriate medical expendi-tures and the lack of data to support the necessity of such high levels of health care spending. It is becoming ever more difficult to justify diagnostic imaging and othermedical procedureswith anecdotal ev-idence, expert opinion, or experience. Instead, great emphasis has been placed on the necessity for evidence-based practice to guid