Schlaganfall und TIA

• Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin. Schlaganfall. AWMF-Leitlinie Nr. 053-011. S3, Stand 2020. www.awmf.org 
• Deutsche Gesellschaft für Allgemeinmedizin (DEGAM). Leitlinie: Hausärztliche Risikoberatung zur kardiovaskulären Prävention. S3, Stand 2017. www.degam.de 
• Deutsche Gesellschaft für Neurologie. Diagnostik und Therapie von Gedächtnisstörungen. AWMF-Leitlinie Nr. 030-124. S2e, Stand 2020. www.awmf.org 
• Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin: Neue Thrombozyten-Aggregationshemmer. Einsatz in der Hausarztpraxis. DEGAM-Leitlinie. AWMF-Leitlinie Nr. 053-041. S2e, Stand 2019. www.awmf.org 
• Deutsche Gesellschaft für Neurologie, Deutsche Schlaganfall-Gesellschaft. Schlaganfall: Sekundärprophylaxe ischämischer Schlaganfall und transitorische ischämische Attacke. AWMF-Leitlinie Nr. 030-133. S3, Stand 2015. www.awmf.org 
• Leitlinien zur Rehabilitation finden Sie im Artikel Rehabilitation nach einem Schlaganfall.

1. Robert Koch-Institut und Destatis. Gesundheit in Deutschland. Gesundheitsberichtserstattung des Bundes. Berlin. www.rki.de  
2. Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin. Schlaganfall. AWMF-Leitlinie Nr. 053-011, Stand 2020. www.awmf.org  
3. DAK Gesundheitsreport 2014, Hamburg 2015. www.dak.de  
4. Rafay MF, Pontigon A-M, Chiang J, et al. Delay to diagnosis in acute pediatric arterial ischemic stroke. Stroke 2009; 40: 58-64. Stroke  
5. Heuschmann PU et al.. Schlaganfallhäufigkeit und Versorgung von Schlaganfällen in Deutschland. Akt Neurol 2010; 37: 333-340. www.kompetenznetz-schlaganfall.de  
6. Kolominsky-Rabas PL, Heuschmann PU, Marschall D et al. Lifetime cost of ischemic stroke in Germany: results and national projections from a population-based stroke registry: the Erlangen Stroke Project. Stroke 2006; 37: 1179-83. www.ncbi.nlm.nih.gov  
7. Winter Y, Wolfram C, Schöffski O et al. Langzeitkrankheitskosten 4 Jahre nach Schlaganfall oder TIA in Deutschland. Nervenarzt 2008; 79: 918-926. www.ncbi.nlm.nih.gov  
8. Gladstone DJ, Spring M, Dorian P, et al. Atrial fibrillation in patients with cryptogenic stroke. N Engl J Med. 2014; 370: 2467-77. doi: 10.1056/NEJMoa1311376 DOI  
9. Lee IM, Paffenbarger RS. Physical activity and stroke incidence. The Harvard Alumni Study. Stroke 1998; 29: 2049-54. pubmed.ncbi.nlm.nih.gov  
10. Easton JD, Albers GW, Caplan LR, et al. Discussion: Reconsideration of TIA terminology and definitions. Neurology. 2004; 62: 29-34. PubMed  
11. O'Donnell MJ, Xavier D, Liu L, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case control study. Lancet 2010; 376: 112-23. PubMed  
12. Pan A, Sun Q, Okereke OI, et al. Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review. JAMA 2011; 306: 1241-9. pubmed.ncbi.nlm.nih.gov  
13. Schmidt M, Hováth-Puhó E, Christiansen CF, et al. Preadmission use of non-aspirin nonsteroidal anti-inflammatory drugs and 30-day stroke mortality. Neurology 2014; 83: 2013-22. doi:10.1212/WNL.0000000000001024 DOI  
14. Cleary P, Shorvon S, Tallis R. Late-onset seizures as a predictor of subsequent stroke. Lancet 2004; 363: 1184-6. PubMed  
15. Bath PMW, Gray LJ . Association between hormone replacement therapy and subsequent stroke: a meta-analysis. BMJ 2005; 330: 342. PubMed  
16. Lidegaard Ø, Løkkegaard E, Jensen A, Skovlund CW, Keiding N. Thrombotic stroke and myocardial infarction with hormonal contraception. N Engl J Med 2012; 366: 2257-66. New England Journal of Medicine  
17. Smeeth L, Thomas SL, Hall AJ et al. Risk of myocardial infarction and stroke after acute infection and vaccination. N Engl J Med 2004; 351: 2611-8. New England Journal of Medicine  
18. Minassian C, D'Aiuto F, Hingorani AD, Smeeth L. Invasive dental treatment and risk for vascular events: a self-controlled case series. Ann Intern Med 2010; 153: 499-506. pubmed.ncbi.nlm.nih.gov  
19. Strazzulo P, D'Elia L, Kandala N-B, Cappuccio FP. Salt intake, stroke, and cardiovascular disease: a meta-analysis of prospective studies. BMJ 2009; 339: b4567. BMJ (DOI)  
20. Haynes MJ, Vincent K, Fischhoff C, et al. Assessing the risk of stroke from neck manipulation: a systematic review. Int J Clin Pract 2012; 66: 940-7. PubMed  
21. Kerkhoff G. Neurovisual rehabilitation: recent developments and future directions. J Neurol Neurosurg Psychiatry 2000; 68: 691-706. PubMed  
22. European Stroke Initiative Executive Commitee and Writing Committee. Recommendations for stroke management. Cerebrovasc Dis 2003; 16: 311-8. PubMed  
23. Adams H jr, Adams RJ, Brott T, et al. Guidelines for the early management of patients with ischemic stroke. a scientific statement from the Stroke Council of The American Stroke Association. Stroke 2003; 34: 1056-83. pubmed.ncbi.nlm.nih.gov  
24. Chalela JA, Kidwell CS, Nentwich LM, et al. Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison. Lancet 2007; 369: 293-8. www.ncbi.nlm.nih.gov  
25. Rothwell PM, Giles MF, Chandratheva A, et al. Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comaprison. Lancet 2007; 370: 1432-42. www.ncbi.nlm.nih.gov  
26. Luengo-Fernandez R, Gray AM, Rothwell PM. Effect of urgent treatment for transient ischaemic attack and minor stroke on disability and hospital costs (EXPRESS study): a prospective population-based sequential study. Lancet Neurol 2009; 8: 235-43. www.ncbi.nlm.nih.gov  
27. Saunders DH, Greig CA, Mead GE. Physical activity and exercise after stroke: review of multiple meaningful benefits. Stroke. 2014;45(12):3742-7. www.ncbi.nlm.nih.gov  
28. Stroke Unit Trialists' Collaboration.Organised inpatient (stroke unit) care for stroke. Cochrane Database Syst Rev. 2013 Sep 11;9:CD000197. doi: 10.1002/14651858.CD000197.pub3. DOI  
29. Drummond AE, Pearson B, Lincoln NB, Berman P. Ten year follow-up of a randomised controlled trial of care in a stroke rehabilitation unit. BMJ 2005; 331: 491-2. British Medical Journal  
30. Roffe C, Nevatte T, Sim J, et al. Effect of routine low-dose oxygen supplementation on death and disability in adults with acute stroke. The Stroke Oxygen Study Randomized Clinical Trial. JAMA 2017; 318: 1125-35. doi:10.1001/jama.2017.11463 DOI  
31. Hajat C, Hajat S, Sharma P. Effects of poststroke pyrexia on stroke outcome: a meta-analysis of studies in patients. Stroke 2000; 31: 410-4. pubmed.ncbi.nlm.nih.gov  
32. Indredavik B, Fjærtoft H, Ekeberg G, Løge A, Mørch B. Benefit of an extended stroke unit service with early supported discharge. A randomized controlled trial. Stroke 2000; 31: 2989-94. pubmed.ncbi.nlm.nih.gov  
33. Ahmed N, Wahlgren N, Grond M, et al. Implementation and outcome of thrombolysis with alteplase 3-4,5 h after an acute stroke: an updated analysis from SITS-ISTR. Lancet Neurol 2010; 9: 866-74. PubMed  
34. Wardlaw JM, Murray V, Berge E, et al. Thrombolysis for acute ischaemic stroke. Cochrane Database Syst Rev. 2014, 7. pubmed.ncbi.nlm.nih.gov  
35. Gumbinger C, Reuter B, Stock C, et al. Time to treatment with recombinant tissue plasminogen activator and outcome of stroke in clinical practice: retrospective analysis of hospital quality assurance data with comparison with results from randomised clinical trials. BMJ 2014; 348: g3429. doi:10.1136/bmj.g3429 DOI  
36. Wardlaw JM, Murray V, Berge E et al. Recombinand tissue plasminogen activator for acute stroke: an updated systematic review and meta-analysis. Lancet 2012;379:2364-72. www.ncbi.nlm.nih.gov  
37. Berkhemer OA, Fransen PSS, van den Berg LA, et al. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med 2014. doi:10.1056/NEJMoa1411587 DOI  
38. Goyal M, Demchuk AM, Menon BK, et al for the ESCAPE Trial Investigators. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med 2015. doi:10.1056/NEJMoa1414905 DOI  
39. Campbell BCV, MitchellPJ, Kleinig TJ, et al for the EXTEND-IA Investigators. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med 2015. doi:10.1056/NEJMoa1414792 DOI  
40. Saver J, Goyal M, Bonafe A, et al for the SWUFT PRIME Investigators. Primary results. Nashville, february 2015. my.americanheart.org  
41. Jovin TG, Chamorro A, Cobo E, et al. Thrombectomy within 8 Hours after Symptom Onset in Ischemic Stroke. N Engl J Med 2015. doi:DOI: 10.1056/NEJMoa1503780 DOI  
42. The IST-3 collaborative group. The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial (IST-3)): a randomised controlled trial. Lancet 2012 Jun 23; 379 (9834): 2352-63. pmid: 22632908 PubMed  
43. Powers WJ, Derdeyn CP, Biller J, et al. 2015 AHA/ASA focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment. Stroke 2015. doi:10.1161/STR.0000000000000074 DOI  
44. Albers GW, Marks MP, Kemp S, et al. Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging. New Engl J Med 2018 Feb 22; 378(8): 708-718. pmid:29364767 PubMed  
45. Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin: Neue Thrombozyten-Aggregationshemmer. Einsatz in der Hausarztpraxis. DEGAM-Leitlinie. AWMF-Leitlinie Nr. 053-041. S2e. Stand 2019 www.awmf.org  
46. Rahman H, Khan S, Nasir F, Meyer M, Kaluski E. Optimal duration of aspirin plus clopidogrel after ischemic stroke or transient ischemic attack. A systematic review and meta-analysis. Stroke 2019;50:947-953. www.ahajournals.org  
47. Ni Chroinin D, Asplund K, Asberg S, et al. Statin therapy and outcome after ischemic stroke: systematic review and meta-analysis of observational studies and randomized trials. Stroke 2013. pmid:23287777 PubMed  
48. Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebocontrolled trial. Lancet 2003; 361: 2005–16. www.ncbi.nlm.nih.gov  
49. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators High-Dose Atorvastatin after Stroke or Transient Ischemic Attack N Engl J Med 2006;355:549-59. www.nejm.org  
50. Manktelow BN, Potter JF Interventions in the management of serum lipids for preventing stroke recurrence. The Cochrane Library 2009, Issue 3. www.ncbi.nlm.nih.gov  
51. Liu N, Cadilhac DA, Andrew NE, et al. Randomized controlled trial of early rehabilitation after intracerebral hemorrhage stroke: difference in outcomes within 6 months of stroke. Stroke. 2014 Dec;45(12):3502-7. PubMed  
52. Legg LA, Drummond AE, Langhorne P. Occupational therapy for patients with problems in activities of daily living after stroke. Cochrane Database of Systematic Reviews 2006: 4: CD003585. doi:10.1002/14651858.CD003585.pub2. europepmc.org  
53. Langhorne P, Taylor G, Murray G et al. Early supported discharge services for stroke patients: a meta-analysis of individual patients' data. Lancet 2005; 365: 501-6. PubMed  
54. Gorelick P, Sacco RL, Smith DB et al. Prevention of a first stroke. A review of guidelines and a multidisciplinary consensus statement from the national stroke asssociation. JAMA 1999; 281:1112-20. www.researchgate.net  
55. Lip G, Nieuwlaat R, Pisters R, Lane D, Crijns H. Refining Clinical Risk Stratification for Predicting Stroke and Thromboembolism in Atrial Fibrillation Using a Novel Risk Factor-Based Approach The Euro Heart Survey on Atrial Fibrillation. CHEST 2010; 137(2):263–272). www.ncbi.nlm.nih.gov  
56. Friberg L, Rosenqvist M, Lip G. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182 678 patients with atrial fibrillation: the Swedish Atrial Fibrillation cohort study. European Heart Journal (2012) 33, 1500–1510. www.ncbi.nlm.nih.gov  
57. Olesen JB, Lip GYH, Hansen ML, et al. Validation of risk stratification schemes for predicting stroke and thromboembolism in patients with atrial fibrillation: nationwide cohort study . BMJ 2011; 342: d124. BMJ (DOI)  
58. Hobbs FD, Roalfe AK, Lip GY, et al. Performance of stroke risk scores in older people with atrial fibrillation not taking warfarin: comparative cohort study from BAFTA trial. BMJ 2011; 342: d3653. BMJ (DOI)  
59. Friberg L, Skeppholm M, Terènt M. Benefit of anticoagulation unlikely in patients with atrial fibrillation and a CHA2DS2-VASc score of 1. J Am Coll Cardiol 2015: 27; 65:225. PMID: 25614418 PubMed  
60. Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin. Neue orale Antikoagulantien (bei nicht valvulärem Vorhofflimmern). AWMF-Registernr. 053/031. S1, Stand 2013. www.degam.de  
61. Wang Y, Wang Y, Zhao X, et al. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N Engl J Med 2013. www.nejm.org  
62. Lee M, Saver JL, Hong KS, et al. Risk-Benefit Profile of Long-Term Dual- Versus Single-Antiplatelet Therapy Among Patients With Ischemic Stroke: A Systematic Review and Meta-analysis. Ann Intern Med 2013 Oct 1;159(7):463-470. PubMed  
63. Kwok CS, Shoamanesh A, Copley HC, et al. Efficacy of antiplatelet therapy in secondary prevention following lacunar stroke: pooled analysis of randomized trials. Stroke 2015; 46: 1014-23. doi:10.1161/STROKEAHA.114.008422 DOI  
64. Gouya G, Arrich J, Wolzt M, et al. Antiplatelet treatment for prevention of cerebrovascular events in patients with vascular diseases: a systematic review and meta-analysis. Stroke 2014 Feb;45(2):492-503. PubMed  
65. Geeganage CM, Diener HC, Algra A et al for the acute antiplatelet stroke trialists collaboration. Dual or mono antiplatelet therapy for patients with acute ischemic stroke or transient ischemic attack: systematic review and meta-analysis of randomized controlled trials. Stroke2012;43:1058-66. pubmed.ncbi.nlm.nih.gov  
66. Zhou YH, Wei X, Lu J et al. Effects of combined aspirin and clopidogrel therapy on cardiovascular outcomes: a systematic review and metaanalysis. PLoS One 2012;7:e31642. journals.plos.org  
67. Palacio S, Hart RG, Pearce LA, et al. Effect of addition of clopidogrel to aspirin on mortality: systematic review of randomized trials. Stroke. 2012;43:2157-62. www.ncbi.nlm.nih.gov  
68. Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale VersorgungsLeitlinie Therapie des Typ-2-Diabetes – Langfassung, 1. Auflage. Version 4. 2013, zuletzt geändert: November 2014. www.awmf.org  
69. Deutsche Gesellschaft für Allgemeinmedizin (DEGAM). Leitlinie: Hausärztliche Risikoberatung zur kardiovaskulären Prävention. S3, Stand 2017 www.degam.de  
70. Mead GE, Hsieh CF, Lee R, et al. Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery. Cochrane database of Systematic Reviews 2012; 11: CD009286. Cochrane (DOI)  
71. Mortensen JK, Larsson H, Johnsen SP, et al. Post stroke use of selective serotonin reuptake inhibitors and clinical outcome among patients with ischemic stroke: a nationwide propensity score-matched follow-up study. Stroke 2013 Feb;44(2):420-6. doi: 10.1161/STROKEAHA.112.674242. DOI  
72. Deutsche Gesellschaft für Neurologie, Deutsche Schlaganfall-Gesellschaft. Schlaganfall: Sekundärprophylaxe ischämischer Schlaganfall und transitorische ischämische Attacke. AWMF-Leitlinie Nr. 030-133, Stand 2015. www.awmf.org  
73. Udell JA, Zawi R, Bhatt DL, et al. Association between influenza vaccination and cardiovascular outcomes in high-risk patients: a meta-analysis. JAMA 2013 Oct 23;310(16):1711-20. PubMed  
74. Deutsche Gesellschaft für Neurologie. Diagnostik und Therapie von Gedächtnisstörungen. AWMF-Leitlinie Nr. 030-124. Stand 2020 www.awmf.org  
75. Snaphaan L, de Leeuw FE. Poststroke memory function in nondemented patients: a systematic review on frequency and neuroimaging correlates. Stroke 2007; 38: 198-203. PubMed  
76. The CLOTS Trials Collaboration. Effectivness of thigh-length graduated compression stockings to reduce the risk of deep vein thrombosis after stroke (CLOTS trial 1): a multicentre, randomised controlled trial. Lancet 2009; 373: 1958-65. PubMed  
77. Oldenbeuving AW, de Kort PL, Jansen BP, et al. Delirium in the acute phase after stroke: Incidence, risk factors, and outcome. Neurology 2011; 76: 993-9. pubmed.ncbi.nlm.nih.gov  
78. Pendlebury ST, Rothwell PM, Oxford Vascular Study. Incidence and prevalence of dementia associated with transient ischaemic attack and stroke: analysis of the population-based Oxford Vascular Study. Lancet Neurol 2019; 18: 248-58. pmid:30784556 PubMed  
79. James P, Ellis CJ, Whitlock RML et al. Relation between troponin T concentration and mortality in patients presenting with an acute stroke: observational study. BMJ 2000; 320:1502-4. pubmed.ncbi.nlm.nih.gov  
80. Bonarenco P, Lavallée PC, Labreuche J et al for the TIAregistry.org Investigators, One-year risk of stroke after transient ischemic attack or minor stroke. NEJM 2016;374:1533-42. www.nejm.org  
81. Amarenco P, Lavallée PC, Labreuche J et al., for the TIAregistry.org Investigators. One-Year Risk of Stroke after Transient Ischemic Attack or Minor Stroke. NEJM 2016; 374(16): 1533-42. pmid:27096581 PubMed  
82. Gesundheitsfragebogen für Patienten (PHQ-D). Universitätsklinikum Heidelberg, 2002. www.klinikum.uni-heidelberg.de  
83. Eriksson M, Glader E-L, Norrving B, Asplund K. Poststroke suicide attempts and completed suicides. Neurology 2015. doi:10.1212/WNL.0000000000001514 DOI  

• Caroline Beier, Dr. med. Fachärztin für Allgemeinmedizin, Hamburg
• Dirk Nonhoff, Dr. med., Facharzt für Allgemeinmedizin, Köln
• Günther Egidi, Dr. med., Arzt für Allgemeinmedizin, Bremen (Review)

Frühere Autoren

• Bent Indredavik, dr. med., seksjonsoverlege, seksjon for hjerneslag, Medisinsk avdeling, St. Olavs Hospital, Trondheim
• Ingard Løge, spesialist i allmennmedisin, redaktør NEL