Acute stroke is the one of the leading factors of morbidity and mortality worldwide. After cardiovascular disease and cancer, stroke ranks as third most common cause of death in industrialised countries. Stroke as the most important cause of morbidity and long-term disability in Europe imposes an enormous economic burden. The average cost from first stroke to death has been calculated for several European countries and is going to increase immediately in the future.
Stroke is associated with significant morbidity as well as mortality, leaving many survivors permanently disabled. More patients survive stroke today than in the past, but a large proportion of them will be disabled for the rest of their lives. Thus a primary goal of stroke management is improving the outcome.
Stroke has, in recent years, been increasingly recognised as a medical emergency. Most treatments, particularly thrombolytic treatment, have a much greater chance of improving stroke outcome if they are started as soon as possible after the onset of symptoms. Educating the public and training health professionals to treat stroke as a true emergency is likely to have real benefits for the outcome of patients with stroke.
The key element of acute stroke management summarises the procedures and therapies currently available for use in acute stroke that may help to improve outcomes for stroke patients. It includes general stroke therapies, treatment of secondary complications, and thrombolytic therapy.
In stroke prevention, primary prevention aims to reduce the risk of stroke in asymptomatic people and secondary stroke prevention focuses on therapies that inhibit the ability of platelets to form thromboemboli. This objective can be achieved either through direct antiplatelet action or by regulating mechanisms that affect platelet aggregation. There have been important advances in antiplatelet therapy in recent years.