Guidelines given by the DSG and DGN concerning stroke therapy--new therapeutic aspects

Surgeries of symptomatic carotid stenose should not be operated on later than 14 days after stroke; until the operation inhibitors of platelet aggregation have to be administered (Table 1). The application of anticoagulants like warfarin or phenprocoumon in case of intracranial stenoses is no longer recommended. Instead 100-300 mg aspirin should prophylactically be given. The risk of suffering a stroke is significantly reduced by the application of antihypertensives. Patients with focal cerebral ischemia should be given 40 mg of Simvastatin which leads to a significant decrease of vascular risk. After the first cerebral ischemic incidenz patients with open foramen ovale of the heart should be given 100-300 mg aspirin. In case of aspirin relapse an oral anticoagulation has to be carried out with an INR of 2.0 up to 3 for at least one year.