Preventing recurrent cerebrovascular events in patients with stroke or transient ischemic attack: The current data

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Abstract

Purpose:

To describe recurrent stroke in relation to the current data, treatment guidelines, diagnostic considerations, risk prevention, and management for the nurse practitioner (NP).

Data sources:

An extensive review of the scientific literature, clinical trials, and clinical guidelines.

Conclusions:

Recurrent stroke is a major health concern. A first ischemic cerebrovascular event or transient ischemic attack (TIA) is a risk factor for future strokes.

Implications for practice:

The risk of recurring stroke has been demonstrated in multiple studies, yet only approximately 5% of stroke patients receive appropriate therapy in a timely manner. The stroke or TIA workup should be completed quickly so that the appropriate treatments and interventions can be initiated to reduce the risk of an additional event. The etiology of the stroke and identification of personal risk factors are important because treatment depends on the specific stroke mechanism. A variety of antiplatelet trials have specific implications for stroke and recurrent stroke. Present treatments include aspirin, aspirin plus extended-release dipyridamole and clopidogrel. The NP plays an important role in ongoing patient education about symptoms, the long-term management of the patient, and reduction of future stroke risk.

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