ABSTRACT
This chapter reviews a number of strategies that are being evaluated as potential treatments. The direct thrombin inhibitor, dabigatran etexilate, has shown promising results in reducing stroke risk in patients with atrial fibrillation and could supersede warfarin therapy. Induction of hypothermia slows tissue metabolism and in experimental models of stroke is effective in protecting the brain from ischemic damage. Angiographic studies in acute stroke suggest that the presence of good collateral blood flow is a determinant of outcome. When administered intravenously within 4.5 hours of symptom onset, thrombolytic therapy with recombinant tissue plasminogen activator improves outcome and is the most effective acute strategy in the management of ischemic stroke. Antagonists of vitamin K such as warfarin have been used for decades in the management of many cardiovascular disorders, including stroke. With the elucidation of the human genome sequence over the decade, pharmacogenomics has rapidly evolved into an important area of stroke medicine research.
