The frontiers of acute stroke management

The field of stroke has rapidly advanced in recent years with more effective reperfusion therapies (thrombolysis and endovascular thrombectomy) applied to a broader range of patients, including using imaging-based selection to treat beyond standard time windows. Recent trials have provided  signals that neuroprotection and specific treatments for intracerebral haemorrhage may be achievable. The range of targeted secondary prevention strategies has also expanded, particularly with direct oral anticoagulants, more potent lipid lowering agents and patent foramen ovale closure.