FOAMEd Wiki - Ischemic Stroke, last updated 4/16/25
Workup and Guidelines
Workup | Source | Year |
Acute Ischemic Stroke | IBCC | 2022 |
Acute Ischemic Stroke Part 1 | EMCrit | 2022 |
Acute Ischemic Stroke Part 2 | EMCrit | 2022 |
VAN Score for LVO | RebelEM | 2018 |
Posterior CVA | Source | Year |
Posterior Circulation Strokes and Dizziness: Pearls and Pitfalls | emDocs | 2017 |
Posterior Circulation Strokes: Why do we miss them, and how do we improve? | emDocs | 2020 |
Posterior Circulation Stroke | CoreEM | 2019 |
Protocols, Workflows, and Guidelines | Source | Year |
2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke .png) | AHA / ASA | 2018 |
2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack | AHA / ASA | 2021 |
Acute Ischemic Stroke – Spoon-Feed Version | JournalFeed $ | 2020 |
Mobile Stroke Units - multi-center RCT | SGEM | 2021 |
SGEM290: Neurologist-Led Stroke Teams Working 9 to 5 | SGEM | 2020 |
Thrombolytic & Antiplatelet Therapy
Thrombolytic Positive Trials | Source | Year |
NINDS I-II | WikiJournalClub | 2015 |
ECASS III | WikiJournalClub | 2017 |
TheNNT V2 (systematic review) | TheNNT | 2019 |
Lytic Debate | Source | Year |
TPA - NNT v1 | The NNT | 2013 |
The Secret of NINDS (Thrombolysis for Acute Stroke) | SGEM | 2014 |
Thrombolytics for Stroke | First10EM | 2017 |
Thrombolysis for Acute Ischemic Stroke - No Retreat, No Surrender | SGEM | 2019 |
Thrombolysis in Acute Ischemic Stroke: Now We Have No Positive RCTs (NINDS II & ECASS Revisited) | REBEL EM | 2020 |
tPA Advocates Be Like – Never Gonna Give You Up (NINDS II & ECASS Revisted) | SGEM | 2020 |
NINDS II and ECASS III Revisited - ACEP | ACEP | 2020 |
TPA - NNT v3 (Systematic Review) | The NNT | 2021 |
Thrombolytics for Acute Ischemic Stroke: Review of NNT v3 | First10EM | 2021 |
Lytic Contraindications | Source | Year |
tPA Contraindications for Ischemic Stroke | MDCalc | |
Are Thrombolytics Safe for Acute Ischemic Strokes in Patients on DOACs? | ALiEM | 2022 |
Timing | Source | Year |
Door-to-TPA Under 20 Minutes | JournalFeed $ | 2018 |
MRI-Guided Thrombolysis for Unknown Time of Onset | JournalFeed $ | 2018 |
Extending the TPA Window to 4.5–9 Hours | REBEL EM | 2019 |
Extending the TPA Window to 9 Hours | JournalFeed $ | 2019 |
Extending the TPA Window - The Case of the Magician's Sleight | EMCrit | 2019 |
Rebel Cast Ep92: Alteplase for Unknown Last Known Well  | REBEL EM | 2020 |
Rebellion21: Alteplase for Stroke of Unknown Time of Onset  | REBEL EM | 2021 |
SGEM325: Thin Ice - MRI-Guided Thrombolysis | SGEM | 2021 |
Dosing | Source | Year |
tPA (Alteplase) Dosing for Ischemic Stroke Calculator | MDCalc | |
Tenecteplase (TNK) Dosing for Ischemic Stroke Calculator | MDCalc | |
EXTEND-IA TNK Part II - TNK dose | REBEL EM | 2020 |
Alteplase (TPA) vs. Tenecteplase | Source | Year |
Tenecteplase vs Alteplase Before Endovascular Therapy for Ischemic Stroke (EXTEND-IA TNK) | Core EM | 2018 |
Tenecteplase vs. Alteplase in Acute Ischemic Stroke | REBEL EM | 2022 |
You Don't Have to Act That Way: TNK for Stroke | SGEM | 2022 |
Antiplatelet Therapy | Source | Year |
PRISMS Trial: Alteplase vs. Aspirin in Minor Stroke | REBEL EM | 2018 |
PRISMS Trial - TPA vs. ASA in Mild CVAs | JournalFeed $ | 2018 |
Thales Trial - DAPT for CVA/TIA | SGEM | 2020 |
Ischemic CVA - THALES - ASA + Ticagrelor | REBEL EM | 2020 |
The ARAMIS Trial: DAPT vs. Alteplase in Minor Stroke | REBEL EM | 2023 |
LVO & Neuroendovascular Therapy
General Evidence & Protocols | Source | Year |
Diagnosis and Neurointerventional Management of Large Vessel Occlusion Acute Ischemic Stroke | emDocs | 2022 |
Endovascular Therapy for Acute Ischemic Stroke | REBEL EM | 2018 |
Ep 120 ED Stroke Management in the Age of Endovascular Therapy | EM Cases | 2019 |
Interventional Therapy for Stroke: The Evidence | First10EM | 2017 |
Endovascular Stroke Treatment Review | JournalFeed $ | 2019 |
Time Window | Source | Year |
52 in 52 – #39: DAWN – Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct | emDocs | 2023 |
DAWN - 6 to 24 Hours after Stroke with a Mismatch Between Deficit and Infarct | The Bottom Line | 2018 |
EVT vs. EVT + tPA – Comparative Trials | Source | Year |
The DIRECT-MT Trial: Are Systemic Lytics Necessary in LVO Treatment? | REBEL EM | 2020 |
REBEL Cast Ep 105: Thrombolysis Before Endovascular Therapy for LVO Acute Ischemic Stroke | REBEL EM | 2021 |
SGEM#333: Do You Gotta Be Starting Something – Like tPA Before EVT? | SGEM | 2021 |
The DEVT + SKIP Trials: Does Systemic Thrombolysis Prior to Endovascular Treatment Improve Outcomes in Large Vessel Occlusion Strokes? | REBEL EM | 2021 |
MR CLEAN-NO IV: Endovascular Treatment for Stroke Compared to Alteplase Followed by Endovascular Treatment: No Difference, But Also Not Not Worse | REBEL EM | 2022 |