Miroslav Brozman
New diagnostic and therapeutic approaches in acute ischemic strokes include mainly the use of multimodal CT and MRI for the evaluation of localization and degree of cerebral hypoperfusion, and the extension of therapeutic window for thrombolysis. Modern diagnostic methods enable precise resolution of transient ischemic attacks and cerebral infarctions, and identification of the cause and extent of impending cerebral damage. Neuroimaging tests should be performed immediately because only early recanalization raises the patient chances for good clinical result. Systemic intravenous thrombolysis during the 3-hours time window is the standard therapeutic method with the possibility to administer thrombolysis up to 4.5 hours from the beginning of symptoms according to the recent European guidelines. Intravenous thrombolysis may be combined with intraarterial administration of the drug or with the direct mechanical recanalization of cerebral arteries. The availability of alteplase in our neurological services enables to increase the proportion of thrombolysed patients and to extend current therapeutic measures.