title: [New aspects of stroke medicine].
abstract: Systemic thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) remains the only effective and approved medical treatment of acute ischemic stroke. Several studies have demonstrated the importance of rapid recanalization. The efficacy of thrombectomy has so far not been sufficiently shown in randomized clinical trials; therefore, inclusion of suitable patients in one of the currently ongoing randomized trials is of great importance. The early treatment with magnesium after acute ischemic stroke during the pre-hospital phase did not prove to be neuroprotective. Intermittent pneumatic compression of the lower extremities in immobilized stroke patients effectively prevents deep venous thrombosis and pulmonary embolism. In patients with lacunar stroke the combination of aspirin and clopidogrel is not superior to aspirin alone and causes more bleeding complications. The novel oral anticoagulants are superior to warfarin in secondary prevention and carry a lower risk of intracranial and systemic bleeding complications. New studies will investigate whether dabigatran or rivaroxaban are superior to aspirin in secondary prevention after cryptogenic stroke.
authors: Universitätsklinik für Neurologie und Schlaganfallzentrum, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland, hans.diener@uk-essen.de.
authors: H C
authors: HC
authors: Diener
authors: B
authors: B
authors: Frank
authors: K
authors: K
authors: Hajjar
authors: C
authors: C
authors: Weimar
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D000077144:Clopidogrel; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices / Q000639:trends*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D020521:Stroke / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control*; D017131:Thrombectomy / Q000639:trends*; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D010959:Tissue Plasminogen Activator; D013988:Ticlopidine