Medical treatment in acute stroke is probably more successful when started rapidly after the onset of symptoms. Therefore a drug is necessary which can be applied by the first physician prior to the diagnosis ischaemic versus haemorrhagic stroke by means of imaging methods. In animal models of ischaemic cerebral damage, a cerebroprotective effect of some calcium antagonists could be demonstrated, among them flunarizine and nimodipine. Flunarizine is effective also in experimental cerebral haemorrhage. The results of the first clinical trials with calcium antagonists are encouraging but inconclusive up to now. In view of the limited possibilities of treatment after a stroke, prevention is stressed.
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Hülser et al. (2008) studied this question.