Progress in stroke prevention: an overview.

Abstract

This overview focuses on the role of secondary prevention strategies in ensuring that the decline in stroke continues. Better awareness of stroke as a major health care problem and the increased number of investigators in Canada who are studying cerebrovascular diseases will help to enhance the management of stroke. Randomized trials with acetylsalicylic acid (ASA) and/or warfarin in patients who have experienced transient ischemic attacks or have been diagnosed as having atrial fibrillation are excellent examples of stroke prevention that helps to decrease the risk of stroke as well as bring researchers together. A multicentre trial on the effectiveness of extracranial-intracranial bypass surgery proved beyond a doubt that the procedure was not useful in most patients. In symptomatic patients with more than 70% carotid stenosis, endarterectomy has been shown to significantly decrease the risk of subsequent cerebral infarction. Several other ongoing trials in patients with asymptomatic bruits and other problems will also aid in stroke prevention.