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45
40
35
30
in rates per 1000
25
20
15
10
0
55-59 60-64 65-69 70-74 75-79 80-84 85-89 90+
Age ranges
Males Females
AVC
15% Hemoragic
. Intraparenchimatos
. Subarahnoidian
85%
Ischemic
• Proceduri endovasculare:
– Trombectomie
– Dilatatie cu stent
Tratament faza acuta
• Antiedematos: Manitol 20%
• profilaxia complicatiilor:
– edem cerebral (HIC) -> decompresie terapeutica de necesitate
– TVP – TEP: heparine GMM
– complicatii decubit
– aspiratie (bronhopneumonie)
După primul AVC riscul de recurenţă a
evenimentelor CV este mare
20 AVC recurent
15
(n=655)
10
0
30 zile 1 an 5 ani
Momentul monitorizării
IM = infarct miocardic.
Adapted from Dhamoon MS et al. Presented at the 57th Annual Meeting of the American Academy of Neurology;
Miami Beach, FL. April 9-16, 2005. S38.005.
Profilaxia secundara
• Medical:
– antitrombotic:
• Antiagregant: aspirina – din prima zi a AVC acut 150 –
300 mg/zi
– clopidogrel, dipiridamol + aspirina
• Anticoagulant: numai in AVC cardioembolice confirmate
– Antivit K: dicumarinic
– Non-antivit k: numai FIA non valvulara
– tratamentul factorilor de risc: HTA (IEC/ sartani), dislipidemie,
ateromatoza a vaselor cerebrale (statine)
• Proceduri:
– Chirurgical: endarterectomie
– Endovascular: stent