Drug therapy of neurovascular disease

The goal of therapy for acute stroke is immediate treatment to reduce the risk of permanent neurologic disability and death. For ischemic stroke, it is imperative to reestablish brain perfusion while at the same time trying to preserve neuronal function. Early treatment of hemorrhagic stroke, particularly subarachnoid hemorrhage, also may improve clinical outcome. Prevention of stroke still remains the most important treatment strategy. In this review, pharmacologic strategies to both prevent and treat thrombotic, embolic, and hemorrhagic strokes are discussed. Treatment modalities for other cerebrovascular disease entities, migraine syndrome, and vascular dementia also are reviewed.