Stroke is an emergency
Identifieur interne : 000F85 ( Main/Exploration ); précédent : 000F84; suivant : 000F86Stroke is an emergency
Auteurs : Nancy Futrell [États-Unis] ; Clark H. Millikan [États-Unis]Source :
- Disease-a-Month [ 0011-5029 ] ; 1996.
English descriptors
- Teeft :
- Abnormality, Acute, Acute stroke, Amaurosis fugax, American heart association, Ancrod, Angina, Angiography, Angioplasty, Anterior, Anterior circulation, Anticardiolipin, Anticardiolipin antibodies, Anticoagulant, Anticoagulant therapy, Anticoagulation, Antihypertensive, Antiphospholipid, Antiphospholipid antibodies, Aphasia, Apraxia, April, Arch intern, Arch neurol, Arteritis, Artery disease, Aspirin, Asymptomatic, Atherosclerosis, Atherosclerotic, Atria1, Atria1 fibrillation, Basilar, Basilar arteries, Basilar artery, Basilar thrombosis, Blood cells, Blood flow, Blood pressure, Blood supply, Blood vessel, Brain tissue, Brainstem, Cardiac, Cardiogenic, Cardiogenic emboli, Cardiogenic embolism, Cardiol, Carotid, Carotid angiography, Carotid arteries, Carotid artery, Carotid endarterectomy, Carotid stenosis, Cerebral, Cerebral edema, Cerebral emboli, Cerebral infarct, Cerebral infarction, Cerebral ischemia, Cerebral vasculitis, Cerebrovascular, Cerebrovascular diseases, Chest radiograph, Clinical course, Clinical diagnosis, Clinical trials, Collagen, Complication, Complication rate, Coronary artery disease, Deep strokes, Doppler, Duplex, Dysfunction, Edema, Elderly patients, Embolic, Embolic stroke, Embolism, Embolus, Emergency room, Endarterectomy, Endarterectomy trials, Engl, Erythematosus, Etiologic, Etiologic factor, Etiology, Extremity, Family history, Fibrillation, Focal area, Focal neurologic dysfunction, Frequent cause, Futrell, Glucose level, Glutamate, Glutamate antagonists, Granulomatosis, Guideline, Heart disease, Hematoma, Hemianopia, Hemiparesis, Hemiplegia, Hemorrhagic, Hemorrhagic transformation, Heparin, Herniation, High risk, Homonymous hemianopia, Hypertension, Imaging, Infarct, Infarction, Intern, Internal capsule, Internal carotid artery, Intubation, Ischemia, Ischemic, Ischemic stroke, Ischemic strokes, Lacune, Lacunes, Large infarcts, Lesion, Lower extremity, Lupus, Lupus anticoagulant, Magnetic resonance angiography, Many centers, Mass effect, Migraine, Migraine patients, Millikan, Moderate strokes, Mortality rate, Myocardial infarction, Myocardial ischemia, Neoplasm, Neurol, Neurologic, Neurologic deficit, Neurologic examination, Neurological disease, Neurologist, Neurology, Nodosa, Noninvasive studies, Nursing home, Occlusion, Penetrating branches, Perfusion, Perfusion pressure, Plaque, Platelet, Platelet aggregates, Platelet inhibitors, Posterior, Posterior circulation, Pregnant women, Preventive therapy, Preventive treatment, Public education, Randomized, Randomized trial, Recent tias, Recurrent, Recurrent stroke, Recurrent tias, Risk factor, Risk factors, Scan, Severe strokes, Speech pathologist, Stenosis, Stroke, Stroke care, Stroke cerebrovasc, Stroke patient, Stroke patients, Stroke prevention, Stroke risk, Stroke unit, Stroke units, Subarachnoid, Subarachnoid hemorrhage, Subarachnoid space, Such patients, Sudden onset, Surgical, Surgical management, Surgical treatment, Symptom, Systemic, Systemic lupus erythematosus, Therapy, Thromboembolic stroke, Thrombolytic, Thrombolytic agents, Thrombolytic therapy, Thrombosis, Thrombus, Tia, Ticlopidine, Tissue damage, Transcranial, Transesophageal echocardiography, Transient hypertension, Transient ischemic attack, Ulcerated plaques, Unstable angina, Vascular neurologists, Vasculitis, Venous, Visual field, Warfarin, Warning signs, Water content, Young patients.
Abstract
Stroke is an emergency. Ischemic stroke is similar to myocardial infarction in that the pathogenesis is loss of blood supply to the tissue, which can result in irreversible damage if blood flow is not restored quickly. Public education is needed to emphasize the warning signs of stroke. Patients should seek medical help immediately, using emergency transport systems. Therapy geared toward minimizing the damage from an acute stroke should be started without delay in the emergency room. This includes measures to protect brain tissue, support perfusion pressure, and minimize cerebral edema. Strategies for improving recovery should also begin immediately. All major medical centers need stroke teams and stroke units. Stroke prevention should be given high priority as a public health strategy. Risk factor management should be part of general health care and should begin in childhood, with emphasis on nutrition, exercise, weight control, and avoidance of tobacco. Health screening and early treatment of hypertension and hypercholesterolemia has decreased the incidence of stroke and heart disease, but these efforts need to be expanded to reach all segments of the population. Basic research has opened the door to new therapies aimed at re-establishing blood flow and limiting tissue damage. Clinical trials have already led to changes in stroke prevention, including studies of carotid endarterectomy and ticlopidine and warfarin therapy (for patients with atrial fibrillation). Trials in progress are testing the usefulness of ancrod, neuroprotective agents, antioxidant agents, anti-inflammatory agents, low-molecular-weight heparin, thrombolytic drugs, and angioplasty. Any delay starting therapy after an acute stroke will result in progressive, irreversible loss of brain tissue. Clinicians should remember that for a stroke patient, time is brain tissue.
Url:
DOI: 10.1016/S0011-5029(96)90003-6
Affiliations:
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tissue</term><term>Brainstem</term><term>Cardiac</term><term>Cardiogenic</term><term>Cardiogenic emboli</term><term>Cardiogenic embolism</term><term>Cardiol</term><term>Carotid</term><term>Carotid angiography</term><term>Carotid arteries</term><term>Carotid artery</term><term>Carotid endarterectomy</term><term>Carotid stenosis</term><term>Cerebral</term><term>Cerebral edema</term><term>Cerebral emboli</term><term>Cerebral infarct</term><term>Cerebral infarction</term><term>Cerebral ischemia</term><term>Cerebral vasculitis</term><term>Cerebrovascular</term><term>Cerebrovascular diseases</term><term>Chest radiograph</term><term>Clinical course</term><term>Clinical diagnosis</term><term>Clinical trials</term><term>Collagen</term><term>Complication</term><term>Complication rate</term><term>Coronary artery disease</term><term>Deep strokes</term><term>Doppler</term><term>Duplex</term><term>Dysfunction</term><term>Edema</term><term>Elderly patients</term><term>Embolic</term><term>Embolic stroke</term><term>Embolism</term><term>Embolus</term><term>Emergency room</term><term>Endarterectomy</term><term>Endarterectomy trials</term><term>Engl</term><term>Erythematosus</term><term>Etiologic</term><term>Etiologic factor</term><term>Etiology</term><term>Extremity</term><term>Family history</term><term>Fibrillation</term><term>Focal area</term><term>Focal neurologic dysfunction</term><term>Frequent cause</term><term>Futrell</term><term>Glucose level</term><term>Glutamate</term><term>Glutamate antagonists</term><term>Granulomatosis</term><term>Guideline</term><term>Heart disease</term><term>Hematoma</term><term>Hemianopia</term><term>Hemiparesis</term><term>Hemiplegia</term><term>Hemorrhagic</term><term>Hemorrhagic transformation</term><term>Heparin</term><term>Herniation</term><term>High risk</term><term>Homonymous hemianopia</term><term>Hypertension</term><term>Imaging</term><term>Infarct</term><term>Infarction</term><term>Intern</term><term>Internal capsule</term><term>Internal carotid artery</term><term>Intubation</term><term>Ischemia</term><term>Ischemic</term><term>Ischemic stroke</term><term>Ischemic strokes</term><term>Lacune</term><term>Lacunes</term><term>Large infarcts</term><term>Lesion</term><term>Lower extremity</term><term>Lupus</term><term>Lupus anticoagulant</term><term>Magnetic resonance angiography</term><term>Many centers</term><term>Mass effect</term><term>Migraine</term><term>Migraine patients</term><term>Millikan</term><term>Moderate strokes</term><term>Mortality rate</term><term>Myocardial infarction</term><term>Myocardial ischemia</term><term>Neoplasm</term><term>Neurol</term><term>Neurologic</term><term>Neurologic deficit</term><term>Neurologic examination</term><term>Neurological disease</term><term>Neurologist</term><term>Neurology</term><term>Nodosa</term><term>Noninvasive studies</term><term>Nursing home</term><term>Occlusion</term><term>Penetrating branches</term><term>Perfusion</term><term>Perfusion pressure</term><term>Plaque</term><term>Platelet</term><term>Platelet aggregates</term><term>Platelet inhibitors</term><term>Posterior</term><term>Posterior circulation</term><term>Pregnant women</term><term>Preventive therapy</term><term>Preventive treatment</term><term>Public education</term><term>Randomized</term><term>Randomized trial</term><term>Recent tias</term><term>Recurrent</term><term>Recurrent stroke</term><term>Recurrent tias</term><term>Risk factor</term><term>Risk factors</term><term>Scan</term><term>Severe strokes</term><term>Speech pathologist</term><term>Stenosis</term><term>Stroke</term><term>Stroke care</term><term>Stroke cerebrovasc</term><term>Stroke patient</term><term>Stroke patients</term><term>Stroke prevention</term><term>Stroke risk</term><term>Stroke unit</term><term>Stroke units</term><term>Subarachnoid</term><term>Subarachnoid hemorrhage</term><term>Subarachnoid space</term><term>Such patients</term><term>Sudden onset</term><term>Surgical</term><term>Surgical management</term><term>Surgical treatment</term><term>Symptom</term><term>Systemic</term><term>Systemic lupus erythematosus</term><term>Therapy</term><term>Thromboembolic stroke</term><term>Thrombolytic</term><term>Thrombolytic agents</term><term>Thrombolytic therapy</term><term>Thrombosis</term><term>Thrombus</term><term>Tia</term><term>Ticlopidine</term><term>Tissue damage</term><term>Transcranial</term><term>Transesophageal echocardiography</term><term>Transient hypertension</term><term>Transient ischemic attack</term><term>Ulcerated plaques</term><term>Unstable angina</term><term>Vascular neurologists</term><term>Vasculitis</term><term>Venous</term><term>Visual field</term><term>Warfarin</term><term>Warning signs</term><term>Water content</term><term>Young patients</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Stroke is an emergency. Ischemic stroke is similar to myocardial infarction in that the pathogenesis is loss of blood supply to the tissue, which can result in irreversible damage if blood flow is not restored quickly. Public education is needed to emphasize the warning signs of stroke. Patients should seek medical help immediately, using emergency transport systems. Therapy geared toward minimizing the damage from an acute stroke should be started without delay in the emergency room. This includes measures to protect brain tissue, support perfusion pressure, and minimize cerebral edema. Strategies for improving recovery should also begin immediately. All major medical centers need stroke teams and stroke units. Stroke prevention should be given high priority as a public health strategy. Risk factor management should be part of general health care and should begin in childhood, with emphasis on nutrition, exercise, weight control, and avoidance of tobacco. Health screening and early treatment of hypertension and hypercholesterolemia has decreased the incidence of stroke and heart disease, but these efforts need to be expanded to reach all segments of the population. Basic research has opened the door to new therapies aimed at re-establishing blood flow and limiting tissue damage. Clinical trials have already led to changes in stroke prevention, including studies of carotid endarterectomy and ticlopidine and warfarin therapy (for patients with atrial fibrillation). Trials in progress are testing the usefulness of ancrod, neuroprotective agents, antioxidant agents, anti-inflammatory agents, low-molecular-weight heparin, thrombolytic drugs, and angioplasty. Any delay starting therapy after an acute stroke will result in progressive, irreversible loss of brain tissue. Clinicians should remember that for a stroke patient, time is brain tissue.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Ohio</li></region></list><tree><country name="États-Unis"><region name="Ohio"><name sortKey="Futrell, Nancy" sort="Futrell, Nancy" uniqKey="Futrell N" first="Nancy" last="Futrell">Nancy Futrell</name></region><name sortKey="Millikan, Clark H" sort="Millikan, Clark H" uniqKey="Millikan C" first="Clark H." last="Millikan">Clark H. Millikan</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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