[Management of stroke in Korea, now]

Abstract

Korea is a rapidly growing aging society and stroke is still the second cause of death, comprised of about 15% of the total death in Korea. But the mortality of stroke is slightly decreasing despite increase of stroke incidence, probably due to improvement of management of stroke and related risk factors. The advent of DWI/ MRA enables us to make more accurate patho-etiological diagnoses of ischemic strokes. With the findings in DWI/ MRA and the new classification policy that entrusts the final judgment to stroke specialists of each hospital, we could further classify the large artery disease of the TOAST classification into in-situ thrombosis, artery to artery embolism, and low-flow infarction and make the most plausible diagnosis of undetermined etiology in the TOAST classification. In this article we reviewed medical and surgical treatment of stroke, especially focusing the clinical practice in Korea. We also provided our results of in vivo experiments with promising drugs and stem cells, too. In conclusion, there are too many uncertain areas of stroke managements yet to be settled. We need larger clinical data pools that are collected based on accurate etiological diagnoses of stroke subtypes on the one hand, and brilliant basic research on the other.