Other Anticoagulant Medications to Prevent Stroke

For those who cannot tolerate aspirin, there are prescription medications such as Ticlopidine (Ticlid) and clopidogrel (Plavix), which have similar anticlotting effects. Vitamin E also has anticlotting properties, but this is a weak effect that does not justify its use as a primary stroke-prevention medication. Obviously, if you have a bleeding disorder, or are prone to excessive bleeding when cut or injured, you should avoid these medications altogether.

Anticoagulants do a good job preventing thrombosis and embolism, but what about bleeding or hemorrhage? Would hemorrhage get worse if an anticlotting medication were used? The answer is yes. The same limitation applies to the use of powerful prescription anticoagulants that are used to treat stroke in its early stages (or a TIA). Heparin is injected acutely for this purpose, and oral warfarin (Coumadin) is a longer-term anticlotting treatment. These anticoagulants are much stronger than aspirin and require frequent blood tests to monitor the risk of excessive bleeding.

In recent years, a powerful anticoagulant with almost immediate action, tissue plasminogen activator (TPA, Alteplase), has been developed. A single dose costs a fortune, but it can be effective in preventing the spread of a stroke in the brain after it has begun. The diagnosis must be precise, because if a hemorrhage is misdiagnosed as a thrombus or embolus, TPA can induce massive bleeding and even death.

Steroids restrict the edema that follows a stroke, and are often given as adjuncts to anticoagulants in the hospital. Acute stroke management is now handled like a heart attack, and the old rule that nothing can be done to stop or reduce the size of a stroke once it has begun is no longer true.

Stroke in its various forms is more common than Alzheimer's disease, and contributes to memory loss in a large number of people. While you may think that your memory loss is caused by the aging process, you may actually have been having ministrokes in the brain, and accurate diagnosis with prevention and treatment can stop this type of memory loss in its tracks.

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