Nearly 800,000 strokes occur in the United States each year, and stroke is the leading cause of preventable permanent disability. Timely recognition and treatment are imperative to reduce stroke-related morbidity and mortality. Given the evidence supporting intravenous thrombolysis and mechanical thrombectomy for ischemic stroke, stroke symptoms must be rapidly identified and mimics quickly excluded prior to therapeutic decisions. Intravenous tissue plasminogen activator is recommended for all qualified patients and patients with presentations suggesting large vessel occlusion should be evaluated for mechanical thrombectomy. Time to treatment is the most important prognostic factor for clinical outcome, highlighting the importance of reliable and efficient local and regional systems of care. (C) 2017 Elsevier Inc. All rights reserved.
