International Journal of Clinical Case Reports, 2025, Vol.15, No.3, 98-109 http://medscipublisher.com/index.php/ijccr 99 synthesizing findings from recent studies, this review seeks to provide a comprehensive understanding of the benefits and challenges associated with AI applications in stroke care, highlighting areas for further research and development. 2 Overview of Cerebrovascular Accidents and Emergency Care 2.1 The pathophysiological basis and main types of cerebrovascular accidents Cerebrovascular accidents (CVAs), commonly known as strokes, are a leading cause of morbidity and mortality worldwide. They are primarily classified into two main types: ischemic and hemorrhagic strokes. Ischemic strokes, which account for approximately 87% of all strokes, occur due to an obstruction within a blood vessel supplying blood to the brain, often caused by atherosclerosis or embolism (Karataş et al., 2022; Antón-Munárriz et al., 2023; Gilotra et al., 2023). Hemorrhagic strokes, on the other hand, result from the rupture of a blood vessel, leading to bleeding within or around the brain. This type of stroke is less common but associated with higher mortality and poorer prognosis (Chennareddy et al., 2021; Deshpande et al., 2023). The pathophysiological basis of ischemic strokes involves the interruption of cerebral blood flow, leading to a cascade of cellular events that result in neuronal injury and death. Hemorrhagic strokes involve the extravasation of blood, which can cause direct damage to brain tissue, increased intracranial pressure, and secondary ischemic injury due to reduced perfusion (Chennareddy et al., 2021; Deshpande et al., 2023; Gilotra et al., 2023). 2.2 Standards of emergency care Emergency care for cerebrovascular accidents is time-sensitive and aims to restore cerebral perfusion and minimize brain damage. The initial assessment includes a rapid clinical evaluation and neuroimaging to determine the type of stroke and appropriate treatment (Tarnutzer et al., 2017; Gilotra et al., 2023; Li et al., 2023). For ischemic strokes, the primary treatment involves thrombolytic therapy with tissue plasminogen activator (tPA) if administered within a specific time window from symptom onset. Mechanical thrombectomy may also be considered for eligible patients with large vessel occlusions (Deshpande et al., 2023; Gilotra et al., 2023). For hemorrhagic strokes, management focuses on controlling bleeding, reducing intracranial pressure, and preventing complications such as rebleeding and vasospasm. Surgical interventions may be necessary in cases of significant hematoma or aneurysm rupture (Tarnutzer et al., 2017; Chennareddy et al., 2021). The use of AI-based clinical decision support systems (AI-CDSS) has shown promise in improving the quality of stroke care by providing guideline-based treatment recommendations and assisting in the rapid interpretation of imaging studies (Figure 1) (Karataş et al., 2022; Li et al., 2023). Figure 1 The framework for cerebrovascular disease clinical decision support system (CDSS) (Adopted from Li et al., 2023) Image caption: EMR, Electronic Medical Record; HIS, Hospital Information System; LIS, Laboratory Information Management System; PACS, Picture Archiving and Communication System; TOAST, Trial of Org 10172 in Acute Stroke Treatment; CISS, Chinese Ischemic Stroke Subclassification (Adopted from Li et al., 2023)
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