[Diagnosis and treatment of cerebral infarction].
Diabetes mellitus (DM) is an independent risk factor for cerebral infarction. About 30 % of atherothrombotic and lacunar types of infarction are associated with DM. Cerebral infarction can be diagnosed with the help of computed tomography (CT), magnetic resonance imaging (MRI) and MR angiography (MRA), as well as by carotid and cardiac ultrasonography. The selection of treatment for cerebral infarction is based on time after onset, clinical subtype and severity. Intravenous recombinant tissue plasminogen activator (rt-PA) is indicated for patients with all clinical types of cerebral infarction within 3 hours after onset. Antiplatelet therapy, anticoagulant therapy, neuroprotectants comprise another choice. Controlling risk factors such as hypertension, DM, dyslipidemia and atrial fibrillation during the chronic phase of cerebral infarction is important to prevent recurrence. Pioglitazone significantly reduced the risk of recurrent stroke in patients with DM. Antiplatelet therapy (aspirin, clopidogrel, cilostazol) should be administered to patients with noncardioembolic infarction and anticoagulant therapy should be applied to those with cardioembolic infarction.
Maruyama
Hajime
H
Department of Neurology, International Medical Center, Saitama Medical University.
Tanahashi
Norio
N
D002544:Cerebral Infarction / Q000175:diagnosis* / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans