Role of anticoagulation in neurological practice.

Abstract

Stroke is a common neurological disorder causing significant mortality and morbidity. The burden of stroke is much more in developing nations, particularly in India due to widely prevalent risk factors like hypertension, diabetes, smoking, metabolic syndrome and sedentary lifestyle1. The stroke burden can be reduced by taking care of modifiable risk factors and administration of preventive medications. Cardioembolic stroke (CES) is one of the subtypes of stroke occurring due to embolization from heart to intracranial vasculature. The common cardiac conditions are non-valvular atrial fibrillation (NVAF), prosthetic heart valve (PHV), dilated cardiomyopathy (DCMP), left atrial appendage thrombus and left atrial myxoma. Of all cases of cerebral infarctions, the cardioembolic stroke accounts for 14-30 per cent cases2. The prevalence of atrial fibrillation (AF) increases with age and it is around 10 per cent at 80 yr of age. AF leads to five-fold increase in risk of stroke and it causes more severe, lethal strokes due to high clot burden in major vessels and causes substantial morbidity and mortality3.