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Review
. 2008 May 10;371(9624):1612-23.
doi: 10.1016/S0140-6736(08)60694-7.

Stroke

Geoffrey A Donnan  1 , Marc Fisher, Malcolm Macleod, Stephen M Davis
Affiliations
Review

Stroke

Geoffrey A Donnan et al. Lancet. .

Abstract

Stroke is the second most common cause of death and major cause of disability worldwide. Because of the ageing population, the burden will increase greatly during the next 20 years, especially in developing countries. Advances have occurred in the prevention and treatment of stroke during the past decade. For patients with acute stroke, management in a stroke care unit, intravenous tissue plasminogen activator within 3 h or aspirin within 48 h of stroke onset, and decompressive surgery for supratentorial malignant hemispheric cerebral infarction are interventions of proven benefit; several other interventions are being assessed. Proven secondary prevention strategies are warfarin for patients with atrial fibrillation, endarterectomy for symptomatic carotid stenosis, antiplatelet agents, and cholesterol reduction. The most important intervention is the management of patients in stroke care units because these provide a framework within which further study might be undertaken. These advances have exposed a worldwide shortage of stroke health-care workers, especially in developing countries.

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Comment in

  • Secondary prevention of stroke.
    Mascitelli L, Pezzetta F, Goldstein MR. Mascitelli L, et al. Lancet. 2008 Sep 20;372(9643):1035; author reply 1036. doi: 10.1016/S0140-6736(08)61437-3. Lancet. 2008. PMID: 18805325 No abstract available.
  • Secondary prevention of stroke.
    Paraskevas KI. Paraskevas KI. Lancet. 2008 Sep 20;372(9643):1036; author reply 1036. doi: 10.1016/S0140-6736(08)61438-5. Lancet. 2008. PMID: 18805327 No abstract available.

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