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Clopidogrel, sold under the brand name Plavix among others, is an antiplatelet medication used to reduce the risk of heart disease and stroke in those at high risk. [10] It is also used together with aspirin in heart attacks and following the placement of a coronary artery stent ( dual antiplatelet therapy ). [ 10 ]
Around the same time, Brunnstrom also described the process of recovery, and divided the process into seven stages. As knowledge of the science of brain recovery improved, intervention strategies have evolved. Knowledge of strokes and the process of recovery after strokes has developed significantly in the late 20th century and early 21st century.
A patient taking anticoagulants—aspirin, clopidogrel, ticagrelol and others—will stop taking them several days before, to prevent excessive bleeding during and after the operation. Warfarin is also stopped for the same reason and the patient starts taking heparin products after the INR falls below 2.0. [20] [21]
Both aspirin and clopidogrel may be useful in the first few weeks after a minor stroke or high-risk TIA. [128] Clopidogrel has less side effects than ticlopidine. [ 127 ] Dipyridamole can be added to aspirin therapy to provide a small additional benefit, even though headache is a common side effect. [ 129 ]
Aside from aspirin, three antiplatelet agents taken by mouth have been approved for use in acute coronary syndromes, clopidogrel, ticagrelor and prasugrel; all reduce platelet aggregation by inhibiting the P2Y 12 receptor, a type of adenosine phosphate receptor, on the surface of platelets. Not all three of them are equally indicated in all ...
Additionally, aspirin induces the formation of NO-radicals in the body, which have been shown in mice to have an independent mechanism of reducing inflammation. This reduces leukocyte adhesion, which is an important step in immune response to infection. There is currently insufficient evidence to show that aspirin helps to fight infection. [18]
Cerebral infarction, also known as an ischemic stroke, is the pathologic process that results in an area of necrotic tissue in the brain (cerebral infarct). [1] In mid to high income countries, a stroke is the main reason for disability among people and the 2nd cause of death. [2]
Hemorrhagic stroke is a rare but serious complication of thrombolytic therapy. If a patient has had thrombolysis before, an allergy against the thrombolytic drug may have developed (especially after streptokinase). If the symptoms are mild, the infusion is stopped and the patient is commenced on an antihistamine before infusion is recommenced.