Emerging Strategies For Prevention And Management Of Revolutionizing Stroke Care-A Review Study

Abstract

Stroke can be defined as a neurological deficit associated with an acute focal injury to the central nervous system. The burden of stroke has increased by 70 percent in the last three decades. The continuing disability attributed to stroke results in a compromised quality of life in most patients. This compels further research to provide better outcomes. The DORIC trial concluded the addition of adjunctive cilostazol in type II diabetes mellitus patients with intermittent claudication symptoms, to be an effective preventive strategy. The beneficial effects of rivaroxaban and aspirin for stroke prevention in patients with coronary and peripheral artery disease have been demonstrated in the COMPASS study. Another such research, the ENCHANTED trial, proposed a modest reduction in symptomatic intracranial haemorrhage (sICH) with low-dose alteplase in ischemic stroke patients. Also, intensive systolic blood pressure (SBP) lowering has been illustrated to result in negative effects in ischemic stroke. In thrombolysis patients, decompressive hemicraniectomy (DCH) indicated favourable outcomes by reducing the intracranial pressure (ICP) and preventing brain herniation. Two left atrial appendage occlusion (LAAO) devices have been investigated in the Amulet IDE trial, which signified a similar efficacy and safety with the Amulet occlude and the Watchman device. One of the recent trials has also demonstrated positive therapeutic outcomes with an NMDA receptor antagonist, memantine, in improving brain functioning, recovering neuronal injury, and reducing cerebral ischemia. This review aims to summarize several research observations to advance the prevention and management of ischemic stroke.