Ischemic Stroke in the Neurocritical Care Unit

Ischemic stroke is the most common diagnosis in the neurointensive care unit (NCCU). Patients with acute ischemic stroke may require rapid interventions for time-sensitive pharmacologic thrombolysis or endovascular thrombectomy. Many such patients will benefit from close monitoring with optimization of hemodynamic variables and observation for complications. In addition, these patients may suffer complications of acute stroke, including expansion of infarction, hemorrhagic transformation, and malignant cerebral edema. The NCCU provides an environment for physiologic monitoring by intensivists and specialized nurses and for rapid early intervention allowing us to optimize outcomes from acute ischemic stroke. This chapter addresses the role of the neurointensivist in the care of patients with acute ischemic stroke.