RT Journal Article SR Electronic T1 An update on hyper-acute management of ischaemic stroke JF Clinical Medicine JO Clin Med FD Royal College of Physicians SP 215 OP 221 DO 10.7861/clinmed.2020-0998 VO 21 IS 3 A1 Ajay Bhalla A1 Mehool Patel A1 Jonathan Birns YR 2021 UL http://www.rcpjournals.org/content/21/3/215.abstract 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.