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Ninety-eight percent favored evaluation for carotid endarterectomy in appropriately sympathetic"good risk"patients in 1988 before proof of efficacy became available.Proof increased the percentage(from 67%to 92%) favoring evaluation in older,sicker,symptomatic patients but not the percentage of those favoring evaluation of bruit patients(1988:33%;1991: 24%).In 1991,a lower percentage recommended warfarin therapy after noncardioembolic transient ischemic attack;this was especially apparent in the vertebrobasilar case(1988:59%;1991:37%).Both years,nine of 10 neurologists recommended heparin therapy for progressing stroke,while half to three-fourths used it after partial stroke or transient ischemic attack.Almost all would use anticoagulants for secondary prophylaxis after suspected cardioembolic stroke.The results reflect a treatment-oriented empirical approach in this community and document quick clinical application of scientific evidence when it became available. |
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anticoagulant,treatment
anticoagulant,treatment in CVD
cerebral ischemia
cerebrovascular accident
cerebrovascular accident,acute management of
endarterectomy,carotid
heparin
neurologic practice
transient ischemic attack
transient ischemic attack,treatment of
treatment of neurologic disorder
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