[Therapeutic aspects of cerebral ischemia]

At the acute stage of cerebral ischemia, the treatment consists of:--general non-specific rules, such as treating a vital emergency, keeping biological parameters within normal limits and preventing complications;--admission in a stroke unit, to decrease mortality without increasing dependence or recurrence risks;--intravenous administration of rt-PA within 3 hours of stroke onset in eligible patients;--in patients who are not eligible for rt-PA, aspirin (160 to 300 mg) to reduce early recurrence and death, even in atrial fibrillation;--decompressive surgery in patients with raised intracranial pressure.

Secondary prevention consists of:--treatment of risk factors for stroke;--aspirin (75 to 325 mg), or clopidogrel, or the association aspirin-dipyridamole in high-risk subjects without cardiopathy, or warfarin in patients with high-risk cardiopathies;--carotid surgery in patients selected by clinical and imaging criteria.