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Neurologia. 2014 Apr;29(3):168-83. doi: 10.1016/j.nrl.2011.06.003. Epub 2011 Sep 19.
To update the ad hoc Committee of the Cerebrovascular Diseases Study Group of The Spanish Neurological Society guidelines on prevention of ischaemic stroke (IS) and Transient Ischaemic Attack (TIA).
We reviewed the available evidence on ischaemic stroke and TIA prevention according to aetiological subtype. Levels of evidence and recommendation levels are based on the classification of the Centre for Evidence-Based Medicine.
In atherothrombotic IS, antiplatelet therapy and revascularization procedures in selected cases of ipsilateral carotid stenosis (70%-90%) reduce the risk of recurrences. In cardioembolic IS (atrial fibrillation, valvular diseases, prosthetic valves and myocardial infarction with mural thrombus) prevention is based on the use of oral anticoagulants. Preventive therapies for uncommon causes of IS will depend on the aetiology. In the case of cerebral venous thrombosis oral anticoagulation is effective.
We conclude with recommendations for clinical practice in prevention of IS according to the aetiological subtype presented by the patient.
更新西班牙神经科学会脑血管疾病研究组特设委员会关于缺血性卒中（IS）和短暂性脑缺血发作（TIA）预防的指南。
我们根据病因亚型回顾了缺血性卒中和TIA预防的现有证据。证据水平和推荐等级基于循证医学中心的分类。
在动脉粥样硬化血栓形成性IS中，抗血小板治疗以及对同侧颈动脉狭窄（70%-90%）的特定病例进行血运重建术可降低复发风险。在心源性栓塞性IS（心房颤动、瓣膜病、人工瓣膜以及伴有壁血栓的心肌梗死）中，预防基于口服抗凝剂的使用。IS罕见病因的预防性治疗将取决于病因。在脑静脉血栓形成的情况下，口服抗凝治疗有效。
我们根据患者呈现的病因亚型对IS预防的临床实践提出了建议。
