Ictus

Per professionisti sanitari. Le informazioni non sostituiscono la valutazione clinica del singolo caso; fanno fede il riassunto delle caratteristiche del prodotto aggiornato e le linee guida citate.

Revisione medica: Dr. med. univ. Daniel Pehböck, DESA, 03.11.2026

Ictus: Riconoscimento – BE-FAST, Stroke mimic – pensare prima alla glicemia, Gestione preospedaliera, Pressione arteriosa, Occlusione di grosso vaso (LVO) e ospedale di destinazione, In ospedale (in breve) – in sintesi per i team di emergenza, anestesia e terapia intensiva, con fonti e revisione medica.

Contenuto del capitolo

1. Riconoscimento – BE-FAST
2. Stroke mimic – pensare prima alla glicemia
3. Gestione preospedaliera
4. Pressione arteriosa
5. Occlusione di grosso vaso (LVO) e ospedale di destinazione
6. In ospedale (in breve)
7. Emorragia intracerebrale (EIC)
8. Bambini (in breve)

Farmaci in questo capitolo

• Glucosio
• Urapidil
• Alteplase
• Tenecteplase
• Concentrato di complesso protrombinico (CCP)
• Fitomenadione
• Idarucizumab
• Andexanet alfa
• Protamina

Fonti e linee guida

1. Ringleb P, Köhrmann M, Jansen O et al. Akuttherapie des ischämischen Schlaganfalls, S2e-Leitlinie, 2021.
2. Prabhakaran S, Gonzalez NR, Zachrison KS et al. 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association. Stroke 2026;57(8):e316–e436 (online 26.01.2026; ersetzt die Leitlinie 2018 mit Update 2019)
3. American Heart Association/American Stroke Association. „Guidelines in Action“.
4. Sandset EC et al. 2025 update to European Stroke Organisation (ESO) guideline on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage. Eur Stroke J 2026;11(5):aakag004 (publiziert 05/2026)
5. Berge E, Whiteley W, Audebert H et al. European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke. Eur Stroke J 2021;6(1):I–LXII.
6. Alamowitch S, Turc G, Palaiodimou L et al. European Stroke Organisation (ESO) expedited recommendation on tenecteplase for acute ischaemic stroke. Eur Stroke J 2023;8(1):8–54.
7. Turc G, Bhogal P, Fischer U et al. European Stroke Organisation (ESO)
8. European Stroke Organisation (ESO) und European Society for Minimally Invasive Neurological Therapy (ESMINT). Guideline on acute management of basilar artery occlusion. Eur Stroke J 2024; J NeuroInterv Surg 2024.
9. Walter S, Audebert HJ et al. European Stroke Organisation (ESO) guidelines on mobile stroke units for prehospital stroke management. Eur Stroke J 2022.
10. Steiner T, Purrucker JC, Aguiar de Sousa D et al. European Stroke Organisation (ESO) and European Association of Neurosurgical Societies (EANS) guideline on stroke due to spontaneous intracerebral haemorrhage. Eur Stroke J 2025;10(4):1007–1086 (online 05/2025; ersetzt die ESO-Leitlinie 2014)
11. Greenberg SM, Ziai WC, Cordonnier C et al. 2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association. Stroke 2022;53:e282–e361.
12. Christensen H, Cordonnier C, Kõrv J et al. European Stroke Organisation Guideline on Reversal of Oral Anticoagulants in Acute Intracerebral Haemorrhage. Eur Stroke J 2019;4(4):294–306.
13. Neurocritical Care Society (NCS) und Society of Critical Care Medicine (SCCM). Treatment of Antithrombotic-Associated Intracranial Hemorrhage in Adults: A Focused Guideline Update. Neurocrit Care 2026, online 24.09.2026 (aktualisiert die NCS/SCCM-Leitlinie 2016)
14. European Society of Anaesthesiology and Intensive Care (ESAIC). Clinical guideline on reversal of direct oral anticoagulants in patients with life threatening bleeding. Eur J Anaesthesiol 2024;41(5):327–350.
15. Ma L, Hu X, Song L et al. The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3)
16. Baharoglu MI, Cordonnier C, Al-Shahi Salman R et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH)
17. Pérez de la Ossa N, Abilleira S, Jovin TG et al. Effect of Direct Transportation to Thrombectomy-Capable Center vs Local Stroke Center on Neurological Outcomes in Patients With Suspected Large-Vessel Occlusion Stroke in Nonurban Areas: The RACECAT Randomized Clinical Trial. JAMA 2022;327:1782–1794 (Einschluss RACE > 4; kein Unterschied im 90-Tage-Outcome; Sekundäranalyse.
18. Pérez de la Ossa N, Carrera D, Gorchs M et al. Design and validation of a prehospital stroke scale to predict large arterial occlusion.
19. Aroor S, Singh R, Goldstein LB. BE-FAST (Balance, Eyes, Face, Arm, Speech, Time): Reducing the Proportion of Strokes Missed Using the FAST Mnemonic. Stroke 2017;48:479–481.
20. Ahnert, Korsen, Bernhard, Böhm. Prähospitale Versorgung des Schlaganfalls. Anästh Intensivmed 2024, Heft 11 (CME)
21. Österreichische Gesellschaft für Neurologie (ÖGN) und Österreichische Gesellschaft für Schlaganfallforschung (ÖGSF). Positionspapier Schlaganfallpfad Österreich.
22. Gesundheit Österreich GmbH (GÖG). Österreichisches Stroke-Unit-Register.
23. Schlaganfallpfad Tirol.
24. Deutsche Schlaganfall-Gesellschaft (DSG). Zertifizierung von Stroke Units (telemedizinisch vernetzte, regionale und überregionale Stroke Unit); Zertifizierungskriterien, Klarstellung 04/2026.
25. Rossaint R, Afshari A, Bouillon B et al. The European guideline on management of major bleeding and coagulopathy following trauma.
26. Deutsche Diabetes Gesellschaft (DDG). S3-Leitlinie Therapie des Typ-1-Diabetes, Version 5, 2023. AWMF-Register-Nr. 057-013.
27. Djakow J, Turner NM, Skellett S et al. European Resuscitation Council Guidelines 2025 Paediatric Life Support. Resuscitation 2025;215 Suppl 1:110767.
28. Riassunti delle caratteristiche dei prodotti autorizzati – prodotto e sezione per ogni dose nell'app.