Treatment of the patient with acute ischemic stroke
Klein GM., Karbalai H., Demchuk A., Buchan A.
Stroke is a cerebrovascular injury that occurs when blood flow to the brain is interrupted. It is the third leading cause of death and the commonest cause of disability in North America. There are many treatable risk factors for ischemic stroke, including high blood pressure, smoking, and high cholesterol. In addition, stroke in the acute stage can be treated with thrombolytic agents, and secondary prevention measures include antiplatelet drugs and anticoagulation in selected patients. The role of the physician in ischemic stroke management is first to establish a specific diagnosis. Stroke can be secondary to paradoxical embolus, cardiogenic embolism, atheroma of the ascending and transverse aorta, atheroma of the carotid vessels or its major branches, or lacunar infarct. About 5 % of all strokes are the result of rare causes, chiefly a complication of other medical problems. Appropriate investigation will attach a precise diagnostic label to each stroke in the majority of cases and help lay out a plan for management. Each diagnostic label carries with it specific implications in terms of acute management, as well as secondary prevention. Appropriate management of the ischemic stroke patient includes a specific diagnosis, specific treatment, and a long-term management plan.