How should acute ischemic stroke be managed in the intensive care unit?

Stroke is one of the leading causes of death and functional disability worldwide. The main focus of acute therapy is to achieve cerebral reperfusion primarily with thrombolytic therapy and/or image-guided selection of patients for mechanical thrombectomy. The interventional treatment is becoming increasingly personalized in that the extent of tissue damage and ischemic penumbra on imaging dictate the treatment strategy. Stroke patients are at considerable risk for neurological complications (malignant infarction, hemorrhagic transformation and seizures) as well as systemic ones (pneumonia, cardiac failure, venous thromboembolic disease) which require intensive monitoring and critical care management.