Audience: Healthcare providers

Developed and produced for http://www.MDPracticeGuide.com, a CME resource for physicians and healthcare providers.

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Primary prevention of stroke requires the management of Atherosclerotic Risk Factors, such as hypertension, diabetes, smoking, and dyslipidemia.

As the risk increases, secondary stroke prevention factors include identifying whether or not the patient has suffered from: prior transient ischemic attack (TIA) / Stroke; coronary artery disease (CAD) / peripheral vascular disease (PVD); asymptomatic carotid stenosis; or atrial fibrillation.

All patients with ischemic stroke or transient ischemic attack should be on antiplatelet therapy (ASA) for secondary prevention of recurrent stroke unless there is an indication for anticoagulation or a contraindication to ASA.

Anticoagulation long term with warfarin is the superior antithrombotic if atrial fibrillation or other definite cardiac source of embolism is identified as the cause of stroke/TIA.

Surgical intervention is very effective in the prevention of stroke in symptomatic severe internal carotid artery stenosis. Earlier intervention yields greatest benefit.