[Concepts for stroke therapy].

Abstract

Thrombolytic therapy and "stroke units" are the main new concepts of stroke therapy that have been recently introduced into clinical practice. Although thrombolysis decreases the likelihood of disability by about 12% with regard to increased mortality and a tenfold increase of bleeding complications, debate over the value of thrombolytic therapy in acute ischaemic stroke continues. Local intra-arterial application of thrombolytic substances, however, is recommended for embolic occlusion of the basilar artery, since thrombolytic therapy reduces mortality in these patients from about 90% to less than 50%. "Stroke units" have been developed to enable rapid evaluation of stroke patients and to improve medical care of the patients. Several studies have shown that stroke unit care of the patients indeed improves outcome with decreased mortality, a better chance of the patient being discharged to home after hospital stay, shorter length of hospital stay, as well as fewer medical complications.