A stroke is usually caused by ischaemia, less frequently by an intracerebral hemorrhage. The distinction between hemorrhagic and ischaemic strokes, as well as the identification of patients requiring immediate recanalization therapy, cannot be made by clinical examination but requires CT imaging. In most patients with an ischemic stroke, large parts of the affected brain area are functionless throughout the first hours, but not yet irreversibly damaged (penumbra tissue). These areas can be saved through early vessel recanalization. In the acute phase of ischaemic stroke, a delay of 15 minutes results in a significant worsening of the neurologic prognosis.With modern endovascular techniques, even patients with the most severe ischemic strokes have a fair chance of neurological recovery, if they are admitted to a specialised centre within the first few hours.
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