Evaluation and management of stroke.
In contrast to myocardial infarction, stroke is a heterogeneous disease with multiple different causes. Determination of stroke mechanism is critical to choosing optimal therapy to prevent recurrence. This article reviews the diagnostic approach to stroke and prognostic and treatment implications of specific stroke mechanisms. Data on the role of antiplatelet and anticoagulant therapy in secondary stroke prevention, as well as the role of these agents and thrombolytic therapy in acute stroke treatment are reviewed. Situations of particular relevance to the practicing hematologist-stroke in the young, patients with multiple recurrent strokes, patients with abnormal hypercoagulable laboratory testing, and treatment of intracerebral hemorrhage following thrombolytic therapy-are discussed.
Cucchiara
Brett L
BL
Department of Neurology, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA. cucchiar@mail.med.upenn.edu
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D001161:Arteriosclerosis / Q000150:complications; D002561:Cerebrovascular Disorders / Q000145:classification / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D002986:Clinical Trials as Topic; D003955:Diagnostic Tests, Routine; D019468:Disease Management; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D011446:Prospective Studies; D055502:Secondary Prevention; D020521:Stroke / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D015912:Thrombolytic Therapy / Q000009:adverse effects; D019851:Thrombophilia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D055815:Young Adult
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors