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    After stroke: Guidelines of Turkish Society of cerebrovascular diseases 2015
    (Turkish Society of Cerebrovascular Diseases, 2015) Bakar, Mustafa; Özdag, Mehmet Fatih; Melek, Ismet; Uludüz, Derya; Uzuner, Gülnur Tekgöl; Armagan, Onur; Özgen, Merih
    In this section, recommendation of recent management approaches about post-stroke complications such as sensorymotor function impairment, drops, epilepsy, depression and dementia will be offered.
  • [ N/A ]
    Öğe
    Primary and secondary prevention in stroke: Approact to diabetes mellitus cases
    (Turkish Society of Cerebrovascular Diseases, 2014) Uludüz, Derya; Duman, Taşkin
    Microangiopathy and macroangiopathy are induced by increased the tendency of atherosclerosis caused by metabolic impairment. The prerevalance of diabetes mellitus is 15-33% in cases with ischemic stroke. Diabetes mellitus is an independent risk factor especially for stroke and it can increase the relative risk (RR) 1.8-6 times for initial stroke. The risk of ischemic stroke is higher in women with diabetes. Individual adjustment of glycemic targets is performed but treatment regulation as to set ? 7.0% of HbA1C is recommended for decreasing the microvascular and macrovascular complications if the history of stroke or TIA are present. The targeted fasting plasma glucose levels should be ranged from 4.0 to 7.0 mmol/L and the targeted plasma glucose levels at postprandial second hour should be ranged from 5.0 to 10.0 mmol/L. Daily physial activity, weight control, blood pressure control, lipid control and life style changes are recommended to all diabetic patients. Also, medical treatment is commonly needed for targeted HbA1C levels. In diabetic patients, Metformin is an effective first-line pharmacotherapy to decrease the stroke risk. Also, monotherapy with fibrates can be considered. It is proposed to set the blood preassure at < 130/80 mmHg with ACEI or ARB hypertension treatments in diabetic patients. Diabetic adults with additionally risk factors should be treated with statins to decrease the risk of initial stroke. The benefit of antiagregant usage to decrease the stroke risk is not clear yet, however aspirin usage can suitable in diabetic patients with increased cardiovascular event risk.