Antiplatelet Drugs in the Management of Cerebral Ischemia

Abstract In this chapter we present the evidence that platelets play significant roles in the development of ischemic stroke, and that their activation can also contribute to the evolution of brain injury. Those observations support the clinical observations that antiplatelet approaches can reduce the incidence of second stroke in the setting of transient ischemic attacks or minor stroke, and second stroke after a completed stroke. However, antiplatelet therapy increases the risk of intracerebral hemorrhage. Aspirin and other antiplatelet agents have been used as adjunctive treatment for carotid artery atherosclerotic disease and cardiac source emboli. Considerations of newer settings for the use of antiplatelet agents are discussed.