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Stroke Treatment in the Setting of Systemic Disease

  • Neurologic Manifestations of Systemic Disease (D Lapides, Section Editor)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Abstract

While the possible stroke risks for more prevalent conditions, such as cardiac disease or cancer, are important to recognize, there are other equally devastating systemic diseases that can affect younger adults and, if not cautious, may be misdiagnosed if stroke is the initial presentation.

Purpose of review

We aim to discuss treatments of three rarer, but important systemic diseases associated with an increased incidence of ischemic stroke, specifically sickle cell anemia, human immunodeficiency virus (HIV), and Takayasu’s arteritis.

Recent findings

Given that individuals with these diseases are now living longer, there is increasingly a two-pronged approach to therapy in order to both (1) control the underlying disease process and (2) address traditional stroke-risk factors.

Summary

Ischemic stroke in a patient with HIV may be due to accelerated atherosclerosis, tobacco abuse, or other traditional stroke-risk factors. Therefore, stroke prevention and management are similar to that of the general population. Stroke in HIV can be due to opportunistic infections, in which case the underlying infection should be treated aggressively. For patients with sickle cell anemia, the focus of treatment is on decreasing HbS to prevent further stroke. Patients with Takayasu’s arteritis are treated with immunosuppression to decrease inflammation and prevent stroke.

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  1. Department of Neurology, The Johns Hopkins University School of Medicine, 600 N Wolf St. Phipps 4-446, Baltimore, MD, 21287, USA

    Karissa C. Arthur MD, Elizabeth Fracica MD, MPH & Michelle C. Johansen MD PhD

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Karissa C. Arthur declares that she has no conflict of interest. Elizabeth Fracica declares that she has no conflict of interest. Michelle C. Johansen declares that she has no conflict of interest..

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Arthur, K.C., Fracica, E. & Johansen, M.C. Stroke Treatment in the Setting of Systemic Disease. Curr Treat Options Neurol 22, 44 (2020). https://doi.org/10.1007/s11940-020-00650-4

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