[Therapeutic aspects of cerebral ischemia].
At the acute stage of cerebral ischemia, the treatment consists of:--general non-specific rules, such as treating a vital emergency, keeping biological parameters within normal limits and preventing complications;--admission in a stroke unit, to decrease mortality without increasing dependence or recurrence risks;--intravenous administration of rt-PA within 3 hours of stroke onset in eligible patients;--in patients who are not eligible for rt-PA, aspirin (160 to 300 mg) to reduce early recurrence and death, even in atrial fibrillation;--decompressive surgery in patients with raised intracranial pressure.
Secondary prevention consists of:--treatment of risk factors for stroke;--aspirin (75 to 325 mg), or clopidogrel, or the association aspirin-dipyridamole in high-risk subjects without cardiopathy, or warfarin in patients with high-risk cardiopathies;--carotid surgery in patients selected by clinical and imaging criteria.
Leys
D
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Equipe d'accueil EA 2691 (Université Lille II). Service de Neurologie et Pathologie neurovasculaire, CHU de Lille, Hôpital Roger Salengro, F 59037 Lille. dleys@chru-lille.fr
D000208:Acute Disease; D002545:Brain Ischemia / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D002544:Cerebral Infarction / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D016894:Endarterectomy, Carotid; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D012307:Risk Factors; D015996:Survival Rate; D015912:Thrombolytic Therapy
D005343:Fibrinolytic Agents