AANS Neurosurgeon | Volume 26, Number 2, 2017

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Is Stroke Prevention Taking a Back Seat to Stroke Treatment?

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A study published in the journal JAMA Neurology recently found that 76 percent of acute stroke patients exhibited some degree of stroke preventability, while 26 percent exhibited high preventability. The results of the study “point to an apparent paradox,” the lead researcher said. “The recent breakthroughs in acute stroke therapy have led to massive efforts to streamline the evaluation of acute stroke patients and institute therapy as fast as feasible. These efforts will lead to more effective mitigation of brain injury consequent to acute ischemic stroke. However, our data suggest that the difficulties faced by acute stroke patients extend far beyond the rather narrow period of emergency stroke treatment. If one takes what could be characterized as a more holistic approach to the problem of stroke, there’s a vast expansion of the window of intervention to include the very stroke prevention efforts that appear to be lacking in so many hyper-acute stroke patients.” During the study, researchers reviewed records of 274 patients (mean age of 67) discharged with a diagnosis of ischemic stroke from UC Irvine Medical Center between 2010 and 2012, and evaluated the preventability of each person’s stroke. Their 10-point scale focused on the effectiveness of treatment for hypertension (0-2 points), hyperlipidemia (0-2 points), atrial fibrillation (0-4 points), and the use of antithrombotic therapy for known prior cerebrovascular and cardiovascular disease (0-2) points. Stroke preventability and stroke treatability are closely associated, according to researchers, and these findings raise the question of whether resources for acute stroke treatment are being directed toward those patients whose strokes are the most preventable. To read more about this study, click here.

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