ABC of arterial and venous disease: Secondary prevention of transient ischaemic attack and stroke

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Abstract
Is it acute cerebrovascular disease?The key features of acute cerebrovascular disease are focal neurological deficit, sudden onset, and absence of an alternative explanation. Abrupt onset of a dense hemiparesis before gradual improvement in a conscious patient rarely causes doubt, but conditions which commonly mimic stroke must be considered (see previous article BMJ 2000;320:920-3).References Antiplatelet Trialists' Collaboration . Collaborative overview of randomised trials of antiplatelet therapy. 1. Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. BMJ 1994;308:81–106. EAFT (European Atrial Fibrillation Trial) Study Group . Secondary prevention in non-rheumatic atrial fibrillation after TIA or minor stroke. Lancet 1993;342:1255–62. Diener HC, Cunha L, Forbes C, Sivenius J, Smets P, Lowenthal A, for the ESPS-2 Working Group . European Stroke Prevention Study 2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurol Sci 1996;143:1–13. CAPRIE Steering Committee . A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 1996;348:1329–39. European Carotid Surgery Trialists' Collaborative Group . Randomised trial of endarterectomy for recently symptomatic carotid stenosis. Final results of the MRC European carotid surgery trial (ECST). Lancet 1998;351:1379–87.

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