China is the world’s leading country in stroke, and stroke has become the first cause of death in China. The incidence of stroke in China is higher than the world average, and the number of people who die from stroke is about 2 million every year. Data released this year by the National Health Planning Commission show that middle-aged people aged 40-64 account for 40% of stroke patients in China, and 60% of those at high risk for stroke are middle-aged. Three out of every four stroke patients have varying degrees of disability. Acute ischemic stroke, also known as cerebral infarction, is the most common type of stroke, accounting for 80% of all strokes. In particular, acute stroke due to large vessel occlusion is often dangerous, with a high mortality and disability rate. In the past, treatment was intravenous thrombolysis, and more recently arterial thrombolysis, but the time window was relatively narrow, and patients beyond the thrombolysis time window could only receive other conservative treatments, a situation that has been broken with advances in stenting techniques. For stroke patients with large arterial occlusion in the anterior circulation, intravenous thrombolysis is possible within 3 hours, arterial thrombolysis is possible within 4.5 hours, and mechanical stent retrieval is possible beyond 4.5 hours and within 6 hours. Stenting pushes back the most effective treatment window for acute ischemic stroke by another 1.5 hours. What is the best treatment for a sudden stroke? In acute ischemic stroke, the most logical treatment in the acute phase is to open the occluded vessel as soon as possible to restore or improve the perfusion of ischemic brain tissue; therefore, thrombolysis and mechanical thrombectomy are milestones in the treatment of acute cerebral infarction! For stroke patients with large arterial occlusion in the anterior circulation, intravenous thrombolysis is feasible within 3 hours, arterial thrombolysis is feasible at 4.5 hours, and stent thrombus retrieval is feasible beyond 4.5 hours but within 6 hours. The time window is consistent with the concept of golden hour. If the time window is exceeded, some or all of the ischemic brain cells become necrotic, which is “irreversible”, and the paralysis and aphasia of the limb will not be easily recovered. Therefore, 3 to 6 hours after acute ischemic stroke is the “golden time” for treatment. The key to acute ischemic stroke treatment is “fast”. Early detection, once a stroke has occurred, is essential to quickly determine whether a stroke has occurred and to start treatment as soon as possible (FAST); 2. However, the reality is not satisfactory. From the time the patient is found after the onset of the disease, transported to a hospital where treatment is available, to the time when the head CT or MR, and the corresponding blood tests are done, the doctor talks to the patient’s family to explain the role and risks of thrombolytic therapy, the family accepts and finally signs the consent ………… to complete This series of procedures takes a certain amount of time, so the percentage of patients who can actually obtain thrombolysis and retrieval treatment within 6 hours is very small. There are many factors affecting the efficiency in practice, and many people miss the best time in this life-saving process, resulting in poor prognosis. Here there should be efforts in many aspects: health awareness of the general public to detect it in the first place; construction of an efficient and swift 120 or 999 rescue platform; implementation of a stroke network and stroke base construction; mobile stroke units to deliver stroke units directly to stroke patients; internal hospital emergency departments, imaging departments, anesthesiology departments, interventional departments, neurological surgery departments to break the barriers between departments and form a multidisciplinary unified and collaborative operation A high level of understanding and cooperation from patients and families. Only when this whole chain is open, the golden time will be seized and the optimal treatment will be taken within the time window to improve the success rate of acute ischemic stroke treatment and reduce the death and disability rate. For the 6-hour time window, it is not completely solidified, and an important factor related to the prognosis is the degree of compensation of the collateral circulation. The time window for posterior circulation cerebral ischemia can be delayed, and the time window can be appropriately delayed under the guidance of imaging. In fact, the above is only about the treatment of acute ischemic stroke. The treatment of acute hemorrhagic stroke is a bit more complicated and its management needs to be equally rapid. Early medical intervention for factors such as surgery of ruptured aneurysms, control of blood pressure, and removal of the occupying effect of the hematoma is necessary to achieve good results. Of course, the best way to deal with stroke is not to mend the fold but to prevent it, to do preventive work in the front, to pay attention to the various risk factors of stroke (ten risk factors of stroke) and to maintain a healthy lifestyle, which is the best way to face the disease.