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Management of patients with stroke: Is it time to expand treatment options?
Author(s) -
Adams Harold P.,
Nudo Randolph J.
Publication year - 2013
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.23948
Subject(s) - stroke (engine) , medicine , stroke recovery , thrombolysis , intensive care medicine , physical medicine and rehabilitation , physical therapy , rehabilitation , cardiology , mechanical engineering , myocardial infarction , engineering
Approximately 700,000 people in the United States have an ischemic stroke annually. Substantial research has tested therapies for the very early treatment of ischemic stroke but, to date, only intravenous thrombolysis and intra‐arterial measures to restore perfusion have shown success. Despite a 15‐year effort to increase the use of these therapies, only approximately 5% of patients with stroke are currently being treated. Although most patients with stroke have some neurological recovery, more than half of stroke survivors have residual impairments that lead to disability or long‐term institutionalized care. Laboratory research has demonstrated several mechanisms that help the brain to recover after a stroke. New pharmacological and cell‐based approaches that are known to promote brain plasticity are emerging from laboratory studies and may soon expand the window for stroke treatment to restore function. It is time to build on this knowledge and to translate the understanding of recovery after stroke into the clinical setting. Measures that might augment recovery should become a major focus of clinical research in stroke in the 21st century. Ann Neurol 2013;74:4–10