Management of thrombosis in stroke.
The management of thrombosis in stroke requires that several questions be answered concerning the diagnosis, aetiology, identification of problems, general and specific aspects of care, and prevention of further vascular events. Stroke is a clinical diagnosis, but cranial computed tomography (CT) scanning is required where there is diagnostic uncertainty or cerebral haemorrhage must be excluded. No specific medical therapies are of proven benefit in acute stroke but several large trials are currently evaluating promising antithrombotic therapies (antiplatelet, anticoagulant and thrombolytic agents). Aspirin has a proven role in the prevention of further vascular events after a stroke or transient ischaemic attack (TIA). In stroke and TIA patients with non-rheumatic atrial fibrillation, warfarin is highly effective at preventing recurrent events. The risk of recurrent stroke in patients with a symptomatic, severe carotid artery stenosis is greatly reduced by endarterectomy.
Langhorne
P
P
Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK.
Dennis
M S
MS
D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000150:complications*; D003657:Decision Making; D006801:Humans; D012307:Risk Factors; D013927:Thrombosis / Q000150:complications / Q000517:prevention & control / Q000628:therapy*