Acute Ischemic Stroke Treatment in 2007

Abstract

A variety of interventions have proven effective in reducing the risk of a first stroke. 1 Nevertheless, each year, more than 700 000 Americans have strokes and more than 150 000 die, making stroke the country's third-leading cause of death. 2 More than 25% of stroke survivors older than age 65 years are disabled 6 months later. 2 On the basis of the results of prospective randomized clinical trials and other studies performed over the past decade, the general approach to the management of acute stroke has evolved from nihilism to active intervention.

Tissue Plasminogen Activator (tPA) and Matrix Metalloproteinases in the Pathogenesis of Stroke: Therapeutic Strategies

“…More than 12 years after FDA approval, tPA remains the only approved therapy for stroke, but because of its severe inclusion criteria (narrow 3 hr time-to-treatment window and no apparent hemorrhagic complications), <5% of stroke patients get benefit from this clot dissolving agent. A detailed set of criteria for selection of stroke patients for tPA therapy was recently presented [22]. Clinical studies have shown that patients receive little or no benefit if tPA therapy is initiated more than 3 hrs after the onset of stroke, which excludes most stroke patients from tPA treatment due to the time required for transportation to medical facilities and proper diagnosis.…”

Use of cereton in neurological care

“…Депрессия приводит к снижению качества жизни па-циента, негативно сказывается на членах его семьи (они ча-ще страдают депрессией) и в результате имеет отрицатель-ные экономические последствия [2][3][4][5].…”

“…Ее основными целями являются сохранение жизнеспособности мозговой ткани в зоне ишемической полутени до момента восстановления мозгового кровотока медикаментозными способами или при развитии коллатерального кровотока, защита нейронов в ус-ловиях реперфузии и уменьшение неврологического дефи-цита [3]. В России в качестве нейропротективной терапии традиционно широко используют различные препараты, од-нако следует отметить, что до настоящего времени эффек-тивность ни одного из них не доказана результатами крупных рандомизированных контролируемых исследований.…”

Approach to and management of the acute stroke patient with atrial fibrillation: A literature review

“…This low percentage is mainly due to delayed presentation to an emergency department beyond the 3-hour treatment window. 15 Clear benefit has been proven for eligible patients if thrombolytic therapy is administered within 3 hours from the initiation of symptoms, although no subgroup analysis has been done in patients with atrial fibrillation. 9 The efficacy of intravenous thrombolysis within the 3-hour time window is similar between different stroke subtypes; therefore, its administration should not be delayed in order to investigate its etiology.…”