For example, advances in MRA are helping to define the nature and extent of extracranial and intracranial pathologies, including aneurysms, occlusive diseases, dissection, moyamoya disease, and arteritides, in many cases eliminating the need for invasive angiography or costly Doppler flow studies. Therapeutic neurointerventional techniques, such as percutaneous angioplasty and the use of stents, may find a role in the treatment and prevention of stroke. Drugs such as NMDA and adhesion molecule antagonists that protect ischemic brain tissue from irreversible damage by excitatory amino acids and by reperfusion effects after thrombolysis may be beneficial when given early after an ischemic stroke. Furthermore, damaging free radicals resulting from reperfusion of oxygenated blood may be minimized with free radical scavengers.
Prevention is, of course, the best treatment.
Treatment of conventional risk factors, such as hypertension, has resulted in significant reduction of stroke. However, identification of genetic profiles for stroke promises to provide a more powerful and meaningful risk-factor portrayal that may lead to earlier interventional measures, such as more aggressive blood pressure control and lipid lowering. Practitioners who are on the front line in terms of being the first ones to see stroke patients are in critical need of an operational approach for stroke, particularly treatable or preventable conditions, such as TIAs, cardioembolic stroke, and subarachnoid hemorrhage. Ultimately, stroke prevention is the best therapy.