[Pharmacotherapy of stroke].

Area of Science:

• Neurology
• Cardiovascular Medicine
• Public Health

Background:

• Stroke is a leading cause of hospitalization in Hungary, with ischemic stroke comprising 85% of cases.
• Current acute stroke management faces limitations in effective causal treatments, particularly for hemorrhagic subtypes.

Purpose of the Study:

• To review the current landscape of acute stroke treatments in Hungary.
• To identify evidence-based therapeutic options and highlight areas needing further research.
• To underscore the significance of primary stroke prevention.

Main Methods:

• Review of existing clinical trial data and systematic reviews on acute stroke pharmacotherapy.
• Analysis of treatment efficacy and safety for ischemic, intracerebral, and subarachnoid hemorrhage.

Main Results:

• Intravenous thrombolysis with recombinant tissue plasminogen activator is the only proven causal treatment for acute ischemic stroke within a 3-hour window.
• No neuroprotectant agents have demonstrated benefit in randomized controlled trials.
• Aspirin shows a modest benefit in reducing death or disability at 6 months post-ischemic stroke.
• Nimodipine is effective in preventing vasospasm after subarachnoid hemorrhage; statins may offer similar benefits.
• No evidence-based pharmacotherapy currently exists for acute intracerebral hemorrhage.

Conclusions:

• Treatment options for acute stroke, especially hemorrhagic stroke, remain limited.
• Primary stroke prevention is crucial due to the scarcity of effective acute interventions.
• Further research is needed for novel thrombolytic agents, extended time windows, and specific treatments for hemorrhagic stroke.