ALTHOUGH THE FIELD of stroke therapeutics has advanced since my last Archives of Neurology review 5 years ago,1
knowledge about treatment of specific cerebrovascular conditions has not yet
caught up with the advances in diagnostic technology.
TREATMENT OF PATIENTS WITH ACUTE BRAIN ISCHEMIA
Stroke Units and Stroke Teams
The most important therapeutic advance during the past decade in the
treatment of patients with acute stroke has been the development of stroke
services and stroke units. Dedicated stroke units have been shown to decrease
mortality, limit stroke morbidity, and allow more patients to retain their
independence and return home after a stroke.2-3
Between the conduct of the 2 large European thrombolytic trials (European
Cooperative Acute Stroke Study [ECASS]4 and
ECASS II5), neurologists in the hospitals engaging
in these trials developed dedicated stroke units. As a result, the morbidity
rate in both the thrombolytic treatment and placebo groups improved dramatically
in the ECASS II trial, and the good results in the placebo-treated group . . . [Full Text of this Article]
Reperfusion
Thrombolysis
Augmenting Blood Flow to Ischemic Regions
Neuroprotection
Modifying Coagulation: Anticoagulants and Antiplatelet Agents in Patients
With Acute Stroke
Treating Increased Intracranial Pressure and Mass Effect
STROKE PROPHYLAXIS
Risk Factor Modification
Surgery and Angioplasty With Stenting of Severely Stenosed Arteries
Agents That Modify Coagulation
Antiplatelet Agents
Warfarin
Recovery and Rehabilitation
