Table of contents
Acute ischemic stroke
What's new
Updated 2024 ESO guidelines for the management of patent foramen ovale after stroke.
Background
Overview
Guidelines
Key sources
Screening and diagnosis
Classification and risk stratification
Diagnostic investigations
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Brain CT/MRI (for acute evaluation)
Brain CT/MRI (for secondary prevention)
CTA/MRA (for acute evaluation)
CTA/MRA (for secondary prevention)
Carotid and vertebral artery imaging
Cardiac imaging
Laboratory tests
ECG
Cardiac monitoring
Chest radiography
Screening for thrombophilic states
Screening for dyslipidemia
Screening for diabetes mellitus
Screening for obstructive sleep apnea
Screening for central hypothyroidism
Respiratory support
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Supplemental oxygen
Hyperbaric oxygen therapy
Medical management
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Intravenous alteplase (timing)
Intravenous alteplase (pre-administration evaluation)
Intravenous alteplase (concomitant thrombectomy)
Intravenous alteplase (bleeding risk)
Intravenous alteplase (complications)
Intravenous alteplase (post-administration care)
Intravenous tenecteplase
Antiplatelet therapy
Anticoagulant therapy
Management of BP (acute treatment, indications and BP targets)
Management of BP (acute treatment, induced hypertension)
Management of BP (secondary prevention)
Management of glucose levels
Management of temperature
Management of cerebral edema (general principles)
Management of cerebral edema (medical management)
Management of cerebral edema (surgical management, supratentorial infarction)
Management of cerebral edema (surgical management, cerebellar infarction)
Management of seizures
Management of dyslipidemia
Therapies with no evidence for benefit
Palliative care
Inpatient care
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Thromboprophylaxis (anticoagulation)
Thromboprophylaxis (compression stockings)
Antibiotic prophylaxis
Pressure ulcer prophylaxis
Nutritional support
Indwelling bladder catheters
Nonpharmacologic interventions
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Physical activity
Weight loss
Smoking cessation
Alcohol consumption
Substance use cessation
Head positioning
Therapeutic procedures
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Indications for thrombectomy (6-24 hours from onset)
Technical considerations for thrombectomy
Intracranial angioplasty/stenting
Carotid artery revascularization
Vertebral artery revascularization
Ischemic preconditioning
Intra-arterial thrombolysis
Laser therapy
Ultrasound-enhanced systemic thrombolysis
Surgical interventions
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Decompressive craniectomy (cerebellar infarction)
Extracranial-intracranial bypass surgery
Specific circumstances
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Female patients (use of oral contraceptives)
Female patients (use of postmenopausal hormone therapy)
Female patients (secondary prevention)
Female patients (patients with migraine with aura)
Female patients (patients with AF)
Female patients (patients with cerebral venous thrombosis, nonpregnant)
Female patients (patients with cerebral venous thrombosis, pregnant)
Female patients (stroke during menstruation)
Pregnant patients (IV alteplase)
Pregnant patients (mechanical thrombectomy)
Pregnant patients (anticoagulation therapy)
Pregnant patients (prevention of preeclampsia)
Pregnant patients (lipid-lowering therapy)
Postpartum patients
Patients with diabetes mellitus
Patients with renal disease
Patients with a history of recent traumatic injury
Patients with a history of recent surgery
Patients with a history of recent ischemic stroke
Patients with hyperdense MCA sign
Patients with severe hypoattenuation lesions
Patients with embolic stroke of undetermined source
Patients with hemorrhagic transformation
Patients with procedural stroke
Patients with drug-associated ischemic stroke
Patients with cerebral venous sinus thrombosis
Patients with neurological deficits
Patients with disability or impairment
Patients with inherited thrombophilias
Patients with antiphospholipid syndrome
Patients with hyperhomocysteinemia
Patients with malignancy
Patients with sickle cell disease (management)
Patients with sickle cell disease (secondary prevention)
Patients with autoimmune vasculitis
Patients with infectious vasculitis
Patients with Fabry disease
Patients with carotid artery stenosis
Patients with vertebral artery stenosis
Patients with carotid or vertebral artery dissection
Patients with intracranial artery dissection
Patients with aortic arch atherosclerosis
Patients with aortic arch dissection
Patients with intracranial aneurysms
Patients with intracranial neoplasms
Patients with Moyamoya disease
Patients with lacunar stroke (IV alteplase)
Patients with lacunar stroke (antiplatelet therapy)
Patients with lacunar stroke (antihypertensive therapy)
Patients with lacunar stroke (therapies with no evidence for benefit)
Patients with carotid web
Patients with FMD
Patients with vertebrobasilar dolichoectasia
Patients with AF (anticoagulation therapy)
Patients with AF (LAA closure)
Patients with patent foramen ovale (indications)
Patients with patent foramen ovale (pre-closure monitoring)
Patients with patent foramen ovale (choice of closure method)
Patients with patent foramen ovale (post-closure care)
Patients with valvular heart disease (antithrombotic therapy)
Patients with valvular heart disease (valvular surgery)
Patients with myocardial infarction
Patients with intracardiac thrombi
Patients with congenital heart disease
Patients with cardiomyopathy
Patients with cardiac tumors
Patients with infective endocarditis
Patients with acute pericarditis
Preventative measures
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Primary prevention (antiplatelet therapy)
Secondary prevention (antiplatelet therapy)
Secondary prevention (health system-based interventions)
Secondary prevention (behavioral changes)
Follow-up and surveillance
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Rehabilitation (motor therapy)
Rehabilitation (evaluation for dysphagia)
Rehabilitation (dysphagia therapy, nutritional support)
Rehabilitation (dysphagia therapy, exercises)
Rehabilitation (dysphagia therapy, oral hygiene)
Rehabilitation (dysphagia therapy, pharmacotherapy)
Rehabilitation (dysphagia therapy, electrical stimulation)
Rehabilitation (dysphagia therapy, acupuncture)
Rehabilitation (cognitive, speech, and sensory therapy)
Rehabilitation (depression and anxiety)
Rehabilitation (return to work)
Quality improvement
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Stroke centers/units
Organization of care
Telemedicine
Outcome measures
Public health measures
Health equity