RT Book, Section A1 Aiyagari, Venkatesh A1 Powers, William J. A1 Diringer, Michael N. A2 Hall, Jesse B. A2 Schmidt, Gregory A. A2 Wood, Lawrence D.H. SR Print(0) ID 2292684 T1 Chapter 63. Cerebrovascular Disease T2 Principles of Critical Care, 3e YR 2005 FD 2005 PB The McGraw-Hill Companies PP New York, NY SN 9780071416405 LK accessanesthesiology.mhmedical.com/content.aspx?aid=2292684 RD 2023/03/25 AB Nonarteriosclerotic causes of stroke occur more commonly in patients admitted to the ICU and should be carefully sought by appropriate diagnostic tests.In patients with acute ischemic stroke, reduction of systemic blood pressure may carry a risk of producing further neurologic deterioration.Intravenous tissue plasminogen activator improves outcome in carefully selected patients with acute ischemic stroke when treatment is instituted within 3 hours of onset.Clinical trials of anticoagulation with heparin or heparin-like drugs in patients with acute cerebral ischemia or infarction have shown no benefit. If other indications for acute anticoagulation are present, these drugs may be given safely.Emergency neurosurgical intervention should be strongly considered in patients with cerebellar infarction or hemorrhage and consequent brain stem compression.Early surgical clipping or coiling of ruptured aneurysms removes the risk of rebleeding and facilitates the effective management of delayed vasospasm and hydrocephalus.