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Key Clinical Updates in Stroke

Dabigatran showed similar efficacy to warfarin in one randomized trial and may be an acceptable alternative.


  • Sudden onset of neurologic deficit of cerebrovascular origin.

  • Patient often has hypertension, diabetes mellitus, tobacco use, atrial fibrillation, or atherosclerosis.

  • Distinctive neurologic signs reflect the region of the brain involved.

General Considerations

In the United States, stroke is the fifth leading cause of death and a leading cause of disability. Risk factors for stroke include hypertension, diabetes mellitus, hyperlipidemia, cigarette smoking, cardiac disease, HIV infection, trigeminal herpes zoster, recreational drug abuse, heavy alcohol consumption, and a family history of stroke.

Strokes are subdivided pathologically into infarcts and hemorrhages. The distinction may be difficult clinically; CT scanning is essential to clarify the pathologic basis (Table 24–3).

Table 24–3.Features of the major stroke subtypes.

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