Summary: Stroke is increasingly referred to as "acute cerebral syndrome," which highlights its analogy to acute coronary syndromes. Despite the lack of validated markers of acute cerebral ischemia to be used in clinical practice, the clinical signs and neuroimaging usually allow an acute stroke to be properly recognized. Advances in the treatment of stroke in the past several years, including the entry of thrombolytic therapy and interventional neuroradiology procedures into the standards, have significantly contributed to the improvement of prognosis. This observation might be attributed both to the decrease in mortality as well as to the reduction in the percentage of permanent disability due to persistent residual focal negative symptoms.
Given the high incidence of stroke, relatively easy identification of risk factors and the possibility of effective treatment of the reversible ones, appropriate prophylactic measures have become a strategic therapeutic goal. Atrial fibrillation (AF) increases the risk of stroke by 2.5- to 4.5-fold and is thought to be responsible for nearly a third of all ischemic strokes. Detailed diagnostics of cryptogenic ischemic stroke frequently identifies previously unrecognized AF, which is the source of cardiovascular embolism as the most probable etiological factor of the ongoing acute ischemia of the central nervous system. As a result, apart from hypertension and diabetes, AF is one of the key diseases where correct diagnosis and treatment can significantly reduce the risk of stroke.
This paper presents a synthetic overview of the most im-portant diagnostic and therapeutic aspects of ischemic stroke and cerebrovascular disease in a patient with atrial fibrillation.