Epidemiology, Natural History, and Clinical Presentation of Large Vessel Ischemic Stroke

Overview

Journal Neurosurgery

Specialty Neurosurgery

Date 2019 Jun 15

PMID 31197329

Citations 93

Authors

Robert C Rennert

Arvin R Wali

Jeffrey A Steinberg

David R Santiago-Dieppa

Scott E Olson

J Scott Pannell

Alexander A Khalessi

Affiliations

Soon will be listed here.

Abstract

Large vessel occlusions (LVOs), variably defined as blockages of the proximal intracranial anterior and posterior circulation, account for approximately 24% to 46% of acute ischemic strokes. Commonly refractory to intravenous tissue plasminogen activator (tPA), LVOs place large cerebral territories at ischemic risk and cause high rates of morbidity and mortality without further treatment. Over the past few years, an abundance of high-quality data has demonstrated the efficacy of endovascular thrombectomy for improving clinical outcomes in patients with LVOs, transforming the treatment algorithm for affected patients. In this review, we discuss the epidemiology, pathophysiology, natural history, and clinical presentation of LVOs as a framework for understanding the recent clinical strides of the endovascular era.

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