Best Clinical Approach for Stroke Management

Abstract

Stroke is the leading cause of severe longterm
disability and death among all diseases
worldwide [1]. Each year in the United States,
more than 690 thousand adults experience
an ischemic stroke [2] and additional 240
thousand experience a transient ischemic
attack (TIA) [3].
Approximately 25% of stroke cases are
recurrent events, often occurring within the
first year of a prior stroke or transient ischemic
attack (TIA) [4]. On average, the annual risk for
future ischemic stroke after an initial ischemic
stroke or TIA is ≈3% to 4% [5]. The mortality
rate is 41% after a recurrent stroke versus 22%
after a primary stroke [6]. In addition, the risk
of recurrent stroke is up to 10% in the week
after a transient ischemic attack (TIA) or minor
stroke [7].
Even though the disability rate has been
improved significantly with acute use of
TPA (tissue plasminogen activator) and
vascular intervention, risk factor control and
antithrombotic usage still play a fundamental
role with absolute risk reduction of new fatal
and nonfatal strokes 30% (95% CI 24%-35%)
[8].