Current and Future Options for the Prevention and Treatment of Stroke

Abstract

At present, no drug has been proven to be effective in the treatment of acute ischaemic stroke or intraparenchymatous haemorrhage. However, investigations of neuroprotective, antiplatelet, anticoagulation and thrombolytic therapies for acute ischaemic stroke are ongoing. Recent studies have provided evidence of the usefulness of therapies for the primary and secondary prevention of ischaemic stroke. In the primary prevention of ischaemic stroke, warfarin is indicated in all patients with atrial fibrillation and at least 1 risk factor for stroke, and for patients greater than 65 years old with lone atrial fibrillation. Warfarin is also indicated for the secondary prevention of ischaemic stroke in patients with atrial fibrillation. Aspirin (acetylsalicylic acid) and ticlopidine are indicated for the secondary prevention of ischaemic stroke in patients without atrial fibrillation. Carotid endarterectomy is beneficial in patients with high grade stenosis and transient ischaemic attacks or nondisabling stroke.