Skip to Main Content

++

  • Image not available. Stroke is one of the leading killers of individuals worldwide.
  • Image not available. Stroke can be either ischemic (87%) or hemorrhagic (13%).
  • Image not available. Transient ischemic attacks (TIAs) require urgent intervention to reduce the risk of stroke, which is known to be highest in the first few days after TIA.
  • Image not available.Carotid endarterectomy should be performed in ischemic stroke patients with 70% to 99% stenosis of the ipsilateral carotid artery, provided that it is done in an experienced center.
  • Image not available. Early reperfusion (<4.5 hours from onset) with tissue plasminogen activator (t-PA) has been shown to reduce the ultimate disability caused by ischemic stroke.
  • Image not available. Antiplatelet therapy is the cornerstone of antithrombotic therapy for the secondary prevention of ischemic stroke.
  • Image not available.Warfarin is the drug of choice for secondary prevention of cardioembolic stroke.
  • Image not available. Blood pressure lowering is effective in both the primary and secondary prevention of both ischemic and hemorrhagic stroke regardless of blood pressure.
  • Image not available. Blood pressure lowering in the acute stroke period (first 7 days) can result in decreased cerebral blood flow and worsened symptoms.
  • Image not available.Statin therapy is recommended for all ischemic stroke patients, regardless of baseline cholesterol, to reduce recurrent vascular events.

++

Upon completion of the chapter, the reader will be able to:

++

  • 1. Describe the impact of stroke on the general population of the United States (incidence and outcomes).
  • 2. Identify the known risk factors for stroke in a patient with either an ischemic or a hemorrhagic stroke.
  • 3. Determine which risk factors are modifiable in a given stroke patient and develop a strategy for risk reduction.
  • 4. Given a patient presentation differentiate cardioembolic stroke from other causes of ischemic stroke.
  • 5. Explain the pathophysiologic mechanism underlying the development of acute ischemic stroke.
  • 6. List the major arteries supplying blood to the brain and their approximate location.
  • 7. Compare and contrast transient ischemic attack (TIA) and acute ischemic stroke.
  • 8. Propose a plan for the diagnostic workup of a patient with presumed ischemic stroke.
  • 9. Discuss the relative merits of anticoagulation with unfractionated heparin in the management of acute ischemic stroke.
  • 10. Given a patient case, select an appropriate antiplatelet regimen for the prevention of secondary ischemic stroke.
  • 11. Develop monitoring plans for patients receiving aspirin, clopidogrel, and dipyridamole + aspirin for the prevention of ischemic stroke.
  • 12. Assess a patient’s eligibility to receive intravenous thrombolytic therapy, given a diagnosis of acute ischemic stroke.
  • 13. Plan a treatment strategy for using intravenous thrombolytic therapy in acute ischemic stroke, including an individual monitoring plan.
  • 14. Determine whether a stroke patient is a candidate for carotid endarterectomy (CEA) for stroke prevention.
  • 15. Compare the cost-effectiveness of the various prevention and treatment strategies used in patients with a history of stroke

++

Image not available. Stroke is the leading cause of disability among adults and the third leading cause of death in the United States, behind cardiovascular disease and all cancers. Despite a 30% reduction in stroke mortality between 1995 and 2005, stroke occurs in the United States at a rate of almost 800,000 per year and results in 150,000 deaths.1 Aggressive efforts to organize stroke care at the local ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.