Post-Stroke Management

Summary Stroke is a major cause of death and disability in industrialised countries. Research has indicated the importance of the time window for intervention with regard to limiting ischaemic and inflammatory injury. Data from recent large therapeutic trials indicate that treatment with recombinant tissue plasminogen activator improves outcome after stroke when given within 3 hours of onset to carefully selected patients. Restoration of perfusion pressure, haemorrheological therapy and anticoagulation are used to limit functional damage. Little is known about effective prevention of ischaemic brain oedema, and the efficacy of current antioedematous management is unproven. Secondary prevention of acute ischaemic attacks is achieved by platelet inhibitors or oral anticoagulation.