Transient ischaemic attacks and stroke.

Abstract

Stroke is the third most common cause of death and a major cause of disability in Australia. Effective prevention is the most powerful strategy for reducing the burden of stroke. Major modifiable causal risk factors for stroke include hypertension, cigarette smoking, diabetes, atrial fibrillation, and carotid stenosis. Atrial fibrillation, in particular, is under-treated in the community; almost all patients should be prescribed warfarin or aspirin, depending on their absolute risk of stroke and risk of bleeding complications. Patients with suspected acute stroke should be referred immediately to a specialist stroke unit for urgent assessment and care by an interested, organised, multidisciplinary team of stroke experts. They should undergo immediate computed tomography brain scan and, if intracranial haemorrhage is excluded, be given aspirin (160-300 mg). Rehabilitation and secondary prevention of recurrent stroke should begin on day one after stroke.