Harriet S.MeyerMD, Contributing EditorDavid H.MorseMS, Journal Review EditorRobertHoganMD, adviser for new media
In the last ten years, the discipline of stroke has evolved from a phenomenological pursuit, which correlated detailed clinical observation with autopsy findings, to one in which acute treatment and active methods of prevention have become paramount.
For treatment and prevention of ischemic stroke, neurologists have at their disposal intravenous and intraarterial thrombolysis, oral and intravenous anticoagulants, multiple antiplatelet agents, carotid endarterectomy and other revascularization procedures, cervical and intracranial angioplasty, angiotensin-converting enzyme inhibitors, and statin drugs. Vascular malformations may be treated by endovascular embolization techniques, neurosurgery, or radiosurgery. Secondary brain injury may be prevented or treated by hemicraniectomy, osmotic agents, or hypothermia. In addition, all the advances of intensive care medicine have allowed the medical maintenance of severely ill stroke patients. The clinician is now faced with the daunting task of deciding which of the many therapies available are right for any given patient.
StrokeStroke: A Practical Guide to Management. JAMA. 2001;286(6):724-725. doi:10.1001/jama.286.6.724-JBK0808-2-1