Time windows in acute ischemic stroke

1. Big picture

In acute ischemic stroke, the central exam idea is: Time is brain.

Every minute of untreated large-vessel ischemia causes loss of neurons, synapses, and axonal function. The purpose of emergency stroke care is to identify whether the patient still has salvageable penumbra and whether reperfusion treatment can safely restore blood flow.

The practical question is not only: “How many hours have passed?” The better modern question is:

How much brain is already infarcted, and how much brain is still salvageable?

Still, for the final exam, you must know the classical time windows very clearly.