Ischemic Stroke
Neurology · ~7% of blueprint- Pathophysiology
- Arterial occlusion (thrombotic or embolic) → focal cerebral ischemia and infarction.
- Signs & Symptoms
- Sudden focal deficit — unilateral weakness, facial droop, aphasia, or neglect (by territory).
- Gold Standard Diagnosis
- Emergent non-contrast CT head to exclude hemorrhage; MRI is more sensitive for early ischemia.
- First-line Treatment
- IV thrombolysis (alteplase or tenecteplase) within ≤4.5 h if eligible; thrombectomy for large-vessel occlusion; then antiplatelet.
High-Yield Pearl
Get a non-contrast CT first — you must rule out hemorrhage before giving tPA.
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Sources
Reviewed September 2026- 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke (replaces the 2018 guideline and 2019 update) — American Heart Association / American Stroke Association, 2026
- StatPearls: Acute Stroke — StatPearls Publishing, 2026
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