7. Disease
        Neurology
            Stroke
Stroke - Prevention

Stroke
- Prevention

Primary prevention

Risk factors

Smoking and hypertension are the two most important modifiable risk factors.

Asymptomatic carotid stenosis

>75% stenosis is associated with 2% ipsilateral stroke per year.

Can consider carotid endarterectomy for patients who are medically fit and stenosis is severe.

 

Stroke and AF

Risk of stroke with non-valvular AF

No risk factors - <<1% risk of stroke per year.

At least one risk factors - 3-5% risk of stroke per year.

>65 y.o. AND at least one other risk factors - 6-12% risk of stroke per year.

 

Warfarin therapy carries a 1% risk of bleeding per year.

 

Secondary prevention

After a TIA or minor stroke, the risk of stroke is

Antiplatelet therapy

Others

Carotid surgery - angioplasty/stenting for carotid stenosis

Warfarin for stroke associated with AF

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