[Current therapy of cerebrovascular infarct]

In general, the acute treatment of ischemic stroke is intended to achieve three goals: a) reduce the volume of the infarct, b) prevent further embolism or thrombotic occlusion of vertebrobasilar or carotid arteries, and c) prevent or react quickly to complications. Methods to expedite clot lysis and restore circulation (thrombolysis) can limit the extent of brain injury and improve outcome. Further therapeutic aims are to optimize collateral perfusion in the penumbra--the area surrounding the core of the ischemic focus--and to reduce ischemia-related secondary injury mechanisms (neuroprotection). Patients at high risk of further embolism or those at risk of acute thrombotic occlusion of a major vessel may--under certain circumstances--be candidates for the application of high-dose heparin.