Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental Neurology2075-54732409-2533Research Center of Neurology44510.17816/psaic445UnknownStroke intensive care: voice a viewPiradovMikhail A.<p>D. Sci. (Med.), Professor, Full Member of the Russian Academy of Sciences, Director</p>annaly-nevrologii@neurology.ruhttps://orcid.org/0000-0002-6338-0392Research Center of Neurology1403200711172207022017Copyright © 2007, Piradov M.A.2007<p>Modern methods of acute stroke treatment are analyzed: traditional and mechanical thrombolysis, intraventricular thrombolysis, recombinant activated factor VIIa for acute intracerebral hemorrhage, hemicraniectomy. Special attention on the problems of cerebral perfusion pressure and multiple organ dysfunction syndrome (MODS) is concentrated. Future perspectives in acute stroke are discussed.</p>traditional and mechanical thrombolysisintraventricular thrombolysisrecombinant activated factor VIIahemicraniectomymultiple organ dysfunction syndromeтрадиционный и механический тромболизисвентрикулярный тромболизисрекомбинантный фактор VIIгемикраниоэктомиясиндром полиорганной недостаточности[Лебедева Е.В. Экстрацеребральная патология и синдром полиорганной недостаточности при тяжелых супратенториальных нетравматических кровоизлияниях. Дис. … канд. мед. наук. М., 2006.][Пирадов М.А., Гулевская Т.С., Гнедовская Е.В. и др. Синдром полиорганной недостаточности при тяжелых формах инсульта (клинико-морфологическое исследование). Неврол. журн. 2006; 5: 9–13.][Alexandrov A.V. CLOTBUST Investigators. Ultrasound-enhanced systemic thrombolysis for acute ischemic stroke. N. Engl. J. Med. 2004; 351: 2170–2178.][Barber R. et al. Prediction of stroke outcome with echoplanar perfusion and diffusion-weighted MRI. Neurol. 1998; 51: 418–426.][Daffertshofer M. Transcranial low frequency ultrasound mediated thrombolysis in brain ischemia: increased risk of hemorrhage with combined ultrasound and tissue plasminogen activator: results of a phase II clinical trial. Stroke 2005; 36: 1441–1446.][DESTINY: Decompressive Surgery for the Treatment of Malignant Infarction of the Middle Cerebral Artery. Internet Stroke center 2006.][Georgiadis D., Schwarz S., Aschoff A., Schwab S. Hemicraniectomy and moderate hypothermia in patients with severe ischemic stroke. Stroke 2002; 33: 1584–1588.][HAMLET: Hemicraniectomy After MCA infarction with Life-threatening Edema Trial. Internet Stroke center 2006.][Intraventricular Hemorrhage Thrombolysis Trial. Internet Stroke center 2006.][Mayer S.A. Recombinant Activated Factor VII Intracerebral Hemorrhage Trial Investigators. Recombinant activated factor VII for acute intracerebral hemorrhage. N. Engl. J. Med. 2005; 352: 777–785.][Mendelow A.D. STICH investigators. Early surgery versus initial conservative treatment in patients with supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomized trial. Lancet 2005; 365 (9457): 387–397.][Smith W.S. MERCI Trial Investigators. Safety and efficacy of mechanical embolectomy in acute ischemic stroke: results of the MERCI trial. Stroke 2005; 36: 1432–1438.][Teernstra O.P. Multicenter randomized controlled trial (SICHH PA). Stereotactic treatment of intracerebral hematoma by means of a plasminogen activator: a multicenter randomized controlled trial (SICHPA). Stroke 2003; 34: 968–974.]