Abstract
This concise review of the epidemiology, pathophysiology, evaluation, acute management,
and prevention of ischemic stroke targets internists, family practitioners, and emergency
physicians who manage patient with stroke.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Heart disease and stroke statistics –2020 update: a report of the American Heart Association.Circulation. 2020; 141: e139-e596
- Tissue plasminogen activator for acute ischemic stroke.N Engl J Med. 1995; 333: 1581-1588
- Thrombolyssis with alteplase 3 to 4.5 hours after acute ischemic stroke.N Engl J Med. 2008; 359: 1317-1329
- for the MR CLEAN Investigators. A randomized trial of intraarterial treatment for acute ischemic stroke.N Engl J Med. 2015; 372: 11-20
- Randomized assessment of rapid endovascular treatment of ischemic stroke.N Eng J Med. 2015; 372: 1019-1030
- for the EXTEND-IA Investigator. Endovascular therapy for ischemic stroke with perfusion-imaging selection.N Engl J Med. 2015; 372: 1009-1018
- Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke.N Engl J Med. 2015; 372: 2285-2295
- Thrombectomy within 8 hours after symptom onset in ischemic stroke.N Engl J Med. 2015; 372: 2296-2306
- Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct.N Engl J Med. 2018; 378: 11-21
- Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging.N Engl J Med. 2018; 378: 708-718
- Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomized trials.Lancet. 2009; 373: 1849-1860
- A randomized, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE).Lancet. 1996; 348: 1329-1339
- European Stroke Prevention Study 2. Dipyridamole and acetylsalicyclic acid in the secondary prevention of stroke.J Neurol Sci. 1996; 143: 1-13
- Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomized, double-blind, placebo-controlled trial.Lancet. 2004; 364: 331-337
- Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events.N Engl J Med. 2006; 354: 1706-1717
- Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke.N Engl J Med. 2008; 359: 1238-1251
- Short-term prognosis after emergency-department diagnosis of transient ischemic attack.JAMA. 2000; 284: 2901-2906
- Clopidogrel with aspirin in acute minor stroke or transient ischemic attack.N Engl J Med. 2013; 369: 11-19
- Clopidogrel and aspirin in acute ischemic stroke and high-risk TIA.N Engl J Med. 2018; 379: 215-225
- Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on Atrial Fibrillation.Chest. 2010; 137: 263-272
- The net clinical benefit of warfarin anticoagulation in atrial fibrillation.Ann Intern Med. 2009; 151: 297-305
- Apixaban versus warfarin in patients with atrial fibrillation.N Engl J Med. 2011; 365: 981-992
- Rivaroxaban versus warfarin in nonvalvular atrial fibrillation.N Engl J Med. 2011; 365: 883-891
- Edoxaban versus warfarin in patients with atrial fibrillation.N Engl J Med. 2013; 369: 2093-2104
- Dabigatran versus warfarin in patients with atrial fibrillation.N Engl J Med. 2009; 361: 1139-1151
- Direct oral anticoagulant (DOAC) versus low-molecular-weight heparin (LMWH) for treatment of cancer associated thrombosis (CAT): A systematic review and meta-analysis.Thrombosis Res. 2019; 173: 158-163
- Rivaroxaban with or without aspirin in stable cardiovascular disease.N Engl J Med. 2017; 377: 1319-1330
- High-dose atorvastatin after stroke or transient ischemic attack.N Engl J Med. 2006; 355: 349-359
- A comparison of two LDL cholesterol targets after ischemic stroke.N Engl J Med. 2020; 382: 9-19
- Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis.N Engl J Med. 1991; 325: 445-453
- Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis.N Engl J Med. 1998; 339: 1415-1425
- Stenting versus endarterectomy for treatment of carotid-artery stenosis.N Engl J Med. 2010; 363: 11-23
- Endarterectomy for asymptomatic carotid stenosis.JAMA. 1995; 273: 1421-1428
- Prevention of disabling and fatal stroke by successful carotid endarterectomy in patients without recent neurological symptoms: randomized controlled trial.Lancet. 2004; 363: 1491-1502
- Comparative effectiveness of carotid endarterectomy vs initial medical therapy in patients with asymptomatic carotid stenosis.JAMA Neurol. 2020; 77: 1110-1121https://doi.org/10.1001/jamaneurol.2020.1427
- Carotid revascularization and medical management for asymptomatic carotid stenosis: protocol of the CREST-2 clinical trials.Int J Stroke. 2017; 12: 770-778
- An index to identify stroke-related vs incidental patent foramen ovale in cryptogenic stroke.Neurology. 2013; 81: 619-625
- Closure or medical therapy for cryptogenic stroke with patent foramen ovale.N Engl J Med. 2012; 366: 991-999
- Percutaneous closure of patent foramen ovale in cryptogenic embolism.N Engl J Med. 2013; 368: 1083-1091
- Closure of patent foramen ovale versus medical therapy after cryptogenic stroke.N Engl J Med. 2013; 368: 1092-1100
- Long-term outcomes of patent foramen ovale closure or medical therapy after stroke.N Engl J Med. 2017; 377: 1022-1032
- Patent foramen ovale closure or anticoagulation vs. antiplatelets after stroke.N Engl J Med. 2017; 377: 1011-1021
- Patent foramen ovale closure or antiplatelet therapy for cryptogenic stroke.N Engl J Med. 2017; 377: 1033-1042
- Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke: Results of an international randomized trial.N Engl J Med. 1985; 313: 1191-1200
- Extracranial-intracranial bypass surgery for stroke prevention in hemodynamic cerebral ischemia: the Carotid Occlusion Surgery Study randomized trial.JAMA. 2011; 306: 1983-1992
- Clinical features and outcome in North American adults with moyamoya phenomenon.Stroke. 2006; 37: 1490-1496
- Stenting versus aggressive medical therapy for intracranial arterial stenosis.N Engl J Med. 2011; 365: 993-1003
- Stroke in patients with symptomatic intracranial stenosis: the VISSIT randomized clinical trial.JAMA. 2015; 313: 1240-1248
- WEAVE trial: final results in 152 on-label patients.Stroke. 2019; 50: 889-894
Article info
Publication history
Published online: August 26, 2021
William J. Mullally, MD, Neurology Series EditorFootnotes
Funding: None.
Conflicts of Interest: None.
Authorship: The author is solely responsible for the content of this manuscript.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.