Stroke medicine involves the management of all forms of stroke and transient ischaemic attack (TIA) and whole patient pathway( which include diagnosis, investigation, acute treatment, rehabilitation and re-integration, secondary prevention and long-term complications). stroke isl the most common cause of severe and acquired disability in adult life, therefore new and emerging interventions can reduce the personal and societal impact of the condition. stroke is a medical emergency,it can cause permanent damage to the nervous system and If it is not promptly diagnosed and treated, it may lead to death
In the majority of patients blockage of an artery in the brain due to clot (thrombosis) is the most common cause of a stroke. The part of the brain that is supplied by the clotted blood vessel is then deprived of blood and oxygen. As a result of the deprived blood and oxygen, the cells of that part of the brain die and the part of the body that it controls stops working. Typically, a cholesterol plaque in a small blood vessel within the brain that has gradually caused blood vessel narrowing ruptures and starts the process of forming a small blood clot.the stroke or TIA will be a manifestation of atherosclerotic disease, and coexisting conditions such as ischaemic heart disease, peripheral vascular disease, diabetes and hyperlipidaemia are common. However, in younger patients, there may be unusual causes of stroke such as arterial dissection, migraine, thrombophilic and vasculitic disorders.
Drug therapy is a relatively recent approach to the treatment of stroke, that will minimize the effects of the stroke Much of the damage caused by a thrombotic or embolic stroke occurs in the first six hours. The development of new clot-dissolving drugs and medications make the brain more resistant to stroke commonly called as neuroprotective agents. medications for the stroke include
- Aspirin is most often used to prevent TIAs and strokes.
- Aspirin combined with dipyridamole is a safe and effective alternative to aspirin.
- clopidogrel may be used for people who cannot take aspirin.
Anticogulants prevent the formation of blood clots and keep existing blood clots from getting bigger. If there is atrial fibrillation,then we will probably take an anticoagulant.
statins lower cholesterol level. It can greatly reduce the risk of stroke in people who have had a TIA. Statins even protect against stroke in people who do not have heart disease or high cholesterol.
blood pressure medicines
If high blood pressure is there then we have to take medicines that lower it. Blood pressure medicines include:
- .Angiotensin II receptor blockers (ARBs)
- . Angiotensin- converting enzyme(ACE) inhibitors
- . Beta blockers
- . Calcium channel blockers
- . Diuretics
Drugs that dissolve clots are known as thrombolytic agents. if these drugs should be given within the first few hours after stroke, they minimize stroke damage.
- Thrombolytic Agents (tissue plasminogen activator [tPA]), widely used to dissolve clots that cause heart attacks, are also effective for dissolving artery-blocking clots in the brain during the critical early stages of stroke. Early administration of tPA after a stroke can reduce neurological damage.
- Neuroprotective Agents – Medications that make the brain less susceptible to the damaging effects of a stroke are called neuroprotective agents.
Article publié pour la première fois le 21/10/2011