[Intensive care in acute ischemia].

Therapy of ischemic infarction has changed enormously during the last decade. This is due to an increase of pathophysiological knowledge on cerebrovascular disease, new diagnostic and intensive-care methods and success in thrombolytic therapy strategies; new neuroprotective drugs are on the way to be used on a routine base. The old fatalistic attitude towards treatment of stroke can nowadays not be justified. The success of stroke treatment is dependent on a fast and consequent therapeutic performing: patients with ischemic stroke who reach the hospital within six hours after onset of symptoms are candidates for thrombolysis. If certain inclusion criteria are fulfilled. Increasingly intracranial pressure is one of the major problems during the acute phase. Anti-edema treatment follows a stepwise scheme. In some selected cases we perform hemicraniectomy. Besides the routine intensive-care monitoring, further monitoring is necessary by evoked potentials, brain pressure probes and Doppler ultrasound.