[Stroke therapy. What is established, what is new?].

Early treatment of a stroke, for example, on a stroke unit reduces neurological deficits and decisively improves survival. Of initial importance is an optimal supply of oxygen. Fever should be rapidly reduced, and blood sugar within the normal range also improves the prognosis. Only when blood pressure is very high is--moderate--lowering recommended. On the contrary, raising the blood pressure and cardiac output may have a positive effect on cerebral bloodflow with fewer neurological deficits resulting. In the case of immobile patients or patients with higher-grade paralysis, antithrombotic measures--increasingly utilizing low molecular-weight heparins--are indicated. Last but not least, early physiotherapy and logopedic treatment have an important role to play. Special forms of therapy such as thrombolysis can be carried out only in well equipped centers with experienced personnel. The use of oxygen-binding plasma substitutes and hypervolemic hemodilution are highly promising future therapeutic options.