Department of Neurology, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA.
Hematology Am Soc Hematol Educ Program. 2009:293-301. doi: 10.1182/asheducation-2009.1.293.
In contrast to myocardial infarction, stroke is a heterogeneous disease with multiple different causes. Determination of stroke mechanism is critical to choosing optimal therapy to prevent recurrence. This article reviews the diagnostic approach to stroke and prognostic and treatment implications of specific stroke mechanisms. Data on the role of antiplatelet and anticoagulant therapy in secondary stroke prevention, as well as the role of these agents and thrombolytic therapy in acute stroke treatment are reviewed. Situations of particular relevance to the practicing hematologist-stroke in the young, patients with multiple recurrent strokes, patients with abnormal hypercoagulable laboratory testing, and treatment of intracerebral hemorrhage following thrombolytic therapy-are discussed.
与心肌梗死不同，中风是一种具有多种不同病因的异质性疾病。确定中风机制对于选择最佳治疗方法以预防复发至关重要。本文综述了中风的诊断方法以及特定中风机制的预后和治疗意义。本文还回顾了抗血小板和抗凝治疗在二级预防中的作用，以及这些药物和溶栓治疗在急性中风治疗中的作用。本文讨论了与以下方面相关的特殊情况：年轻患者中风、多次复发性中风患者、实验室检查异常高凝状态患者、溶栓治疗后脑出血的治疗。
