Stroke and TIA. Prevention and management of cerebrovascular events in primary care.
Stroke is a major cause of death and disability in the United States. Control of risk factors--particularly hypertension, diabetes, elevated serum lipids, and atrial fibrillation--can significantly reduce the incidence of stroke. Platelet antiaggregant therapy has a role in primary and secondary stroke prevention. Patients with transient ischemic attacks presenting with carotid stenosis > 70% can be managed surgically, whereas those with less stenosis can be treated with platelet antiaggregant therapy. Acute stroke is a medical emergency. Thrombolytic therapy with tissue plasminogen activator within 3 hours of event onset can significantly improve outcomes in selected ischemic stroke patients. Patients with intracerebral hemorrhage usually present with acute onset of identifiable neurologic deficits.
Weinberger
Jesse
J
Department of Neurology, Mount Sinai School of Medicine, New York, USA.
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D016893:Carotid Stenosis / Q000150:complications / Q000517:prevention & control; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000628:therapy; D011320:Primary Health Care / Q000379:methods*; D018570:Risk Assessment / Q000379:methods; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D014481:United States
D000925:Anticoagulants