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Current advances in the management of stroke

Stroke is currently one of the most devastating public health problems. It is the third leading cause of death and the leading cause of serious long-term disability in the United States. It affects an estimated 700,000 persons each year, and only about two-thirds of those with a new or recurrent stroke survive. Unfortunately, lingering motor and cognitive deficits that often accompany a stroke can be demoralizing to the survivors, relegating many productive individuals to the role of dependent. The costs associated with the acute treatment, long-term care, and lost productivity of stroke survivors are a significant burden to the individual and to society. These concerns have provided the impetus for extensive research efforts to clarify the causes and pathophysiology of stroke and to develop effective acute and preventive interventions. The status of these efforts was addressed recently by stroke experts at the Second Annual Advances in Stroke Management conference. This supplement presents an overview of those proceedings.

Evidence that platelets play an integral role in the pathophysiology of thromboembolic stroke is indisputable. Platelets normally contribute to clot formation and vascular repair. However, under pathologic conditions they participate in the formation of vascular-occluding thrombi and emboli. Therefore, acute and preventive treatments focus on platelets and other elements of the coagulation system.

Cardiac disease and atherosclerotic cerebrovascular disease leading to stroke are often coincident. In fact, stroke patients …