Acute ischemic stroke: A guideline-based overview of evaluation and management

JAAPA. 2025 May 1;38(5):13-20. doi: 10.1097/01.JAA.0000000000000203. Epub 2025 Apr 24.

Abstract

Stroke is the fifth most common cause of death in the United States, and projections suggest that its incidence will increase in the coming decade. Of all stroke cases, 85% are caused by vascular occlusion, resulting in infarction to the brain, in a condition more specifically known as acute ischemic stroke (AIS). The American Heart Association (AHA)/American Stroke Association (ASA) guideline addresses early management of AIS for providers' use in ensuring rapid evaluation and imaging for patients suspected to be affected. The guideline also aids providers in determining and delivering the most appropriate interventions upon AIS diagnosis. This article reviews the AHA/ASA AIS guideline and highlights key components of care, such as patient evaluation, criteria for fibrinolysis and mechanical thrombectomy, postacute care, and hospital discharge with secondary prevention measures.

Keywords: acute ischemic stroke; cerebrovascular accident; fibrinolysis; guideline; mechanical thrombectomy; prevention.

Publication types

  • Review

MeSH terms

  • American Heart Association
  • Humans
  • Ischemic Stroke* / diagnosis
  • Ischemic Stroke* / therapy
  • Practice Guidelines as Topic*
  • Secondary Prevention
  • Thrombectomy
  • Thrombolytic Therapy
  • United States