Stroke Prevention in Clinical Practice
Comprised of short chapters written in a succinct and bulleted style, with clear diagrams and figures to illustrate where appropriate, Stroke Prevention in Clinical Practice is ideal for the busy doctor looking for a comprehensive pocket-sized guide to th
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Stroke Prevention in Clinical Practice
Daryll M. Baker
Daryll M. Baker, PhD, FRCS Consultant Vascular Surgeon Royal Free Hospital London, UK
British Library Cataloguing in Publication Data Baker, Daryll M. Stroke prevention in clinical practice 1. Cerebrovascular disease – Prevention 2. Cerebrovascular disease – Diagnosis 3. Cerebrovascular disease – Treatment 4. Transient ischemic attack – Diagnosis I. Title 616.8 105 Library of Congress Control Number: 2007926595 ISBN 978-1-85233-964-7
e-ISBN 978-1-84628-728-2
Printed on acid-free paper © Springer-Verlag London Limited 2008 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms of licences issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers. The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore free for general use. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. 987654321 Springer Science+Business Media springer.com
Preface
Stroke is the third most common cause of death in the world. Furthermore, for those who survive, stroke is the most common cause of severe disability, such that after a year, 25% are still dependent on someone else for everyday activities, and within 5 years, a third of these will have suffered a second stroke. Clearly, every effort to reduce the incidence and severity of stroke needs to be taken. This handbook considers the different ways of reducing the risk of ischaemic stroke. A summary of the significance of each risk factor is followed by an outline on how to make the diagnosis both on the basis of clinical features and with investigations. How to modify the risk factor is then considered along with the associated risks of intervention and evidence for the recommendation. Relevant references are given if more detailed information is required.
Contents
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
v
I. Introduction 1. The Significance of Stroke . . . . . . . . . . . . . . . . . . . . . . . . .
3
2. Identifying Patients at Risk of Ischemic Stroke . . . .
7
3. Investigating Patients at Risk of Stroke . . . . . . . . . . . . 15 II. Reducing the Risk of Stroke by Reducing Embolic Events 4. Antiplatelet Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 5. Reducing Cardioembolic Events . .
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