PT - JOURNAL ARTICLE AU - Ajay Bhalla AU - Mehool Patel AU - Jonathan Birns TI - An update on hyper-acute management of ischaemic stroke AID - 10.7861/clinmed.2020-0998 DP - 2021 May 04 TA - Clinical Medicine PG - clinmed.2020-0998 4099 - http://www.rcpjournals.org/content/early/2021/05/03/clinmed.2020-0998.short 4100 - http://www.rcpjournals.org/content/early/2021/05/03/clinmed.2020-0998.full AB - This article aims to provide a comprehensive overview of key advances on various aspects of hyper-acute management of acute ischaemic stroke. These include neuroimaging, acute stroke unit care, management of blood pressure, reperfusion therapy including intravenous thrombolysis, mechanical thrombectomy and decompressive hemicraniectomy for malignant stroke syndrome. The challenge ahead is to ensure these evidence-based treatments are now being delivered and implemented to maximise the benefits across the population.