Stroke aha guidelines

1. Latest AHA/ASA Guidelines for
Stroke Management
• Neurology Perspective
• For Doctors

2. Objectives
• • Review latest AHA/ASA stroke guidelines
• • Acute ischemic stroke updates
• • Primary & secondary prevention
• • Practical neurology takeaways

3. Guideline Overview
• • AHA/ASA evidence-based guidelines
• • Acute stroke, prevention, rehabilitation
• • Focus on ischemic stroke

4. Stroke Classification
• • Ischemic stroke
• • Hemorrhagic stroke
• • TIA

5. Primary Prevention – Overview
• • 2024 updated guideline
• • Focus on modifiable risk factors
• • Social determinants of health

6. Lifestyle & Diet
• • Mediterranean-style diet
• • Physical activity ≥150 min/week
• • Reduce sedentary behavior

7. Risk Factor Control
• • Hypertension
• • Diabetes
• • Dyslipidemia
• • Obesity

8. Time is Brain
• • Early recognition (FAST)
• • EMS activation
• • Organized stroke systems

9. Initial Evaluation
• • Noncontrast CT/MRI
• • CTA/CTP or MRI for LVO selection

10. IV Thrombolysis
• • Alteplase within 4.5 hours
• • Wake-up stroke with DWI–FLAIR mismatch

11. Blood Pressure Management
• • Pre-tPA <185/110 mmHg
• • Post-tPA <180/105 mmHg

12. Mechanical Thrombectomy
• • LVO eligible
• • 6–16 hrs (DAWN/DEFUSE-3)
• • Up to 24 hrs selected cases

13. Antiplatelets – Acute Phase
• • Aspirin within 24–48 hrs
• • Delay if tPA used

14. Dual Antiplatelet Therapy
• • Minor stroke/TIA
• • Aspirin + Clopidogrel for 21 days

15. Secondary Prevention – BP & Lipids
• • BP target <130/80 mmHg
• • High-intensity statins
• • LDL <70 mg/dL

16. Secondary Prevention –
Antithrombotics
• • Antiplatelets for non-cardioembolic stroke
• • Anticoagulation for AF

17. Other Preventive Strategies
• • Diabetes control
• • Smoking cessation
• • Weight management

18. Special Populations
• • Women & pregnancy-related risk
• • Social determinants of health

19. Future Directions
• • New acute stroke guideline expected
• • Advances in rehab & imaging

20. Key Take-Home Points
• • Prevention is crucial
• • Rapid reperfusion saves brain
• • Aggressive secondary prevention