New treatments for stroke.

Stroke is the third leading cause of death and the leading cause of adult disability in the United States. With an annual incidence of over 500,000, stroke has enormous social and economic consequences. Ischemic stroke comprises over 80% of all strokes, with strokes caused by intracerbral hemorrhage and subarachnoid hemorrhage making up the rest. Recent advances in the understanding of stroke risk factors and the mechanisms of nervous system damage in acute stroke, especially ischemic stroke, have led to new therapies for both prevention and treatment. Anticoagulation with warfarin can prevent cardioembolic stroke resulting from atrial fibrillation. Carotid endarterectomy can prevent stroke caused by internal carotid artery stenosis. Tissue plasminogen activator, a clot-dissolving medication, has recently been proven effective in acute ischemic stroke if administered within three hours of onset. Despite these advances, stroke remains common, and most acute stroke unfortunately remains untreatable. Current and future approaches emphasize educating the public and healthcare professionals regarding stroke warning signs and the need for emergent care. Active clinical research is exploring even newer treatments based on the scientific basis of stroke neurobiology.