The main focus is on early diagnosis, early treatment and active prevention for possible causes. Early prophylactic treatment should be given to those with clear risk factors for ischemic stroke, such as hypertension, diabetes mellitus, atrial fibrillation and carotid artery stenosis. Antiplatelet agents aspirin 50-100mg/d and ticlopidine 250mg/d have positive effect on secondary prevention of stroke and are recommended; intermittent period should be included in long-term medication and used with caution for those with bleeding tendency. 1, cerebral embolism patients have a high chance of re-embolism, so it is necessary to take preventive measures. Patients with atrial fibrillation with hypertension, diabetes mellitus or heart failure, patients with artificial heart valve implantation, and patients with mitral stenosis with chronic rheumatic heart disease and atrial fibrillation are also high-risk groups, and preventive measures should be taken even if cerebral embolism does not occur. 2, a number of large-scale clinical trials clearly demonstrate that adjusted doses of oral warfarin can reduce cerebral embolism in high-risk groups by 2/3.
Patients with chronic rheumatic heart disease with mitral stenosis and those with prosthetic heart valves should take oral warfarin. Aspirin is far less effective than warfarin. However, the degree of anticoagulation must be strictly controlled with warfarin.