Acute treatment

Marine‐derived n‐3 fatty acids therapy for stroke

Abstract Background Currently, with stroke burden increasing, there is a need to explore therapeutic options that ameliorate the acute insult. There is substantial evidence of a neuroprotective effect of marine‐derived n‐3 polyunsaturated fatty acids (PUFAs) in experimental stroke, leading to a better functional outcome. Objectives To assess the effects of administration of marine‐derived n‐3 PUFAs […]

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Prehospital stroke scales as screening tools for early identification of stroke and transient ischemic attack

Abstract Background Rapid and accurate detection of stroke by paramedics or other emergency clinicians at the time of first contact is crucial for timely initiation of appropriate treatment. Several stroke recognition scales have been developed to support the initial triage. However, their accuracy remains uncertain and there is no agreement which of the scales perform […]

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Percutaneous vascular interventions versus intravenous thrombolytic treatment for acute ischaemic stroke

Abstract Background Most ischaemic strokes are caused by blockage of a cerebral artery by a thrombus. Intravenous administration of recombinant tissue plasminogen activator given within 4.5 hours is now standardtreatment for this condition. Percutaneous vascular interventionsuse an intra‐arterial, mechanical approach for thrombus disruption or removal (thrombectomy). Recent randomised trials indicate thatpercutaneous vascular interventions are superior […]

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Antibiotic therapy for preventing infections in patients with acute stroke

Abstract Background Stroke is the main cause of disability in high-income countries and ranks second as a cause of death worldwide. Infections occur frequently after stroke and may adversely affect outcome. Preventive antibiotic therapy in the acute phase of stroke may reduce the incidence of infections and improve outcome. In the previous version of this […]

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Antithrombotic treatment after stroke due to intracerebral haemorrhage

Abstract Background Survivors of stroke due to intracerebral haemorrhage (ICH) are at risk of thromboembolism. Antithrombotic (antiplatelet or anticoagulant) treatments may lower the risk of thromboembolism after ICH, but they may increase the risks of bleeding. Objectives To determine the overall effectiveness and safety of antithrombotic drugs for people with ICH. Search methods We searched […]

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Cerebrolysin for acute ischaemic stroke

Abstract Background Cerebrolysin is a mixture of low-molecular-weight peptides and amino acids derived from pigs’ brain tissue, which has potential neuroprotective and neurotrophic properties. It is widely used in the treatment of acute ischaemic stroke in Russia, Eastern Europe, China, and other Asian and post-Soviet countries. Objectives To assess the benefits and risks of cerebrolysin […]

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Nitric oxide donors (nitrates), L-arginine, or nitric oxide synthase inhibitors for acute stroke

Abstract Background Nitric oxide (NO) has multiple effects that may be beneficial in acute stroke, including lowering blood pressure, and promoting reperfusion and cytoprotection. Some forms of nitric oxide synthase inhibition (NOS-I) may also be beneficial. However, high concentrations of NO are likely to be toxic to brain tissue. This is an update of a […]

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Low-molecular-weight heparins or heparinoids versus standard unfractionated heparin for acute ischaemic stroke

Abstract Background Low-molecular-weight heparins (LMWHs) and heparinoids are anticoagulants that may have more powerful antithrombotic effects than standard unfractionated heparin (UFH) but a lower risk of bleeding complications. This is an update of the original Cochrane Review of these agents, first published in 2001 and last updated in 2008. Objectives To determine whether antithrombotic therapy […]

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Immediate versus delayed treatment for recently symptomatic carotid artery stenosis

Abstract Background The timing of surgery for recently symptomatic carotid artery stenosis remains controversial. Early cerebral revascularization may prevent a disabling or fatal ischemic recurrence, but it may also increase the risk of hemorrhagic transformation, or of dislodging a thrombus. This review examined the randomized controlled evidence that addressed whether the increased risk of recurrent […]

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Intraoperative mild hypothermia for postoperative neurological deficits in intracranial aneurysm patients

Abstract Background Rupture of an intracranial aneurysm causes aneurysmal subarachnoid haemorrhage, which is one of the most devastating clinical conditions. It can be classified into five Grades using the Hunt-Hess or World Federation of Neurological Surgeons (WFNS) scale. Grades 4 and 5 predict poor prognosis and are known as ‘poor grade’, while grade 1, 2, […]

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