News on stroke
SPENGOS K.

Stroke is an etiologically heterogeneous disease entity with enormous medical and social impact. Stroke demographics and risk profiles suggest increasing numbers of stroke patients in the upcoming years in the Western countries. These perspectives underline the burden of stroke and make clear that stroke care in primary, secondary and tertiary level needs to be improved. In terms of acute treatment intravenous thrombolysis with rtPA is the only established, safe and effective treatment of acute ischemic stroke when admitted within the first three hours after stroke onset. Several ongoing studies investigate further ways of improving its efficacy and allowing a longer therapeutic time window. On the other hand, recent results on the efficacy of intravenous factor VII application for the treatment of acute hemorrhagic stroke were rather discouraging. In terms of secondary stroke prevention several large scaled trials provided important evidence. Aggressive control of risk factor is indicated. Antihypertensive medication is indicated even in not hypertensive stroke survivors. Effective blood pressure control is warranted. Statins are also indicated in order to achieve hypercholesterolemia control and their protective effect also involves the coronary arteries. Oral anticoagulation is indicated in patients with atrial fibrillation regardless from their age. Besides the complex and more sophisticated secondary preventive measures modern stroke diagnostics allow the early visualization of the underlying pathology and give important information about the etiopathogenesis. However, modern stroke care is not limited in all that. Besides acute treatment, diagnostics and stroke prevention, stroke rehabilitation and control of stroke complications play a crucial role. Symptomatic epilepsy and vascular dementia are well known complications that are often observed among stroke survivors. Post-stroke depression is another late complication of stroke that raised newly the interest of neurologists and psychiatrists. This is also the main topic of this daily seminar that is organized by the ENCEPHALOS society in order to provide the updated evidence on this important issue to interested colleagues of both specialties. Encephalos 2008, 45(4):197-201.

Key words: Stroke, diagnostics, treatment, prevention post-stroke depression.