Stroke: Symptoms and Drug Treatment
Strokes are cerebrovascular accidents with CNS effects. Strokes can be categorized as ischemic (inadequate oxygen) or hemorrhagic (excess blood). Most ischemic strokes are caused by thrombi or emboli caused by cardiac or cerebrovascular disease, such as arteriosclerosis involving cerebral blood vessels. Early treatment intervention reduces subsequent neuronal damage and functional loss. The most common current drug therapies for ischemic stroke involve use of intravenous thrombolytic agents, such as alteplase or reteplase (tissue plasminogen activators), anistreplase (prodrug: streptokinase plus recombinant human plasminogen), streptokinase, and urokinase (all plasminogen activators). The most important adverse effect of these drugs is bleeding (cerebral hemorrhage). Lowdose aspirin (COX1 inhibitor) is given for stroke prevention. Hemorrhagic stroke requires anticoagulant or surgical intervention. Research efforts now focus on drugs that may limit the extent of CNS damage after stroke.