Cerebrovascular disease

Therapy-based rehabilitation services for stroke patients at home

Abstract Background Stroke Unit care is now accepted as an effective service model for hospital care, but the effectiveness of outpatient care is less certain. This review focuses on therapy-based rehabilitation services targeted at stroke patients living at home. Objectives To assess the effects of therapy-based rehabilitation services targeted towards stroke patients resident in the […]

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Chelation therapy for atherosclerotic cardiovascular disease

Abstract Background Chelation therapy is being promoted and practiced all over the world as a form of alternative medicine in the treatment of atherosclerotic cardiovascular disease. It has been recommended as a safe, relatively inexpensive and non-surgical method of restoring blood flow in atherosclerotic vessels. At present the benefit of chelation therapy remains controversial at […]

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Fibrinolytic therapy for intraventricular hemorrhage in adults

Abstract Background Spontaneous or secondary intraventricular hemorrhage is a marker of poor prognosis for hemorrhagic stroke. It can cause hydrocephalus and require ventricular shunt placement, result in permanent neurological deficits or death. Fibrinolytic agents injected into the ventricular system could dissolve blood clots, increase the clearance of blood from the ventricles and hence improve outcome. […]

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Anticoagulants versus antiplatelet agents for acute ischaemic stroke

Abstract Background Antiplatelet agents produce a small, but worthwhile benefit in long-term functional outcome and survival, and have become standard treatment for acute ischaemic stroke. Anticoagulants are often used as an alternative treatment, despite evidence that they are ineffective in producing long-term benefits. We wanted to review trials which have directly compared anticoagulants and antiplatelet […]

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Lubeluzole for acute ischaemic stroke

Abstract Background Experimental studies have shown that ischaemic insults cause excess release of excitatory amino acid (EAA) neurotransmitters, particularly glutamate. Glutamate re-uptake is impaired under ischaemic conditions. In preclinical models of stroke, antagonists of excitatory amino acids or of glutamate release protect against ischaemic injury, even when administered after the ischaemic insult. Lubeluzole is a […]

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Gangliosides for acute ischaemic stroke

Abstract Background Gangliosides may have a protective effect on the central and peripheral nervous systems. Objectives To assess the effect of exogenous gangliosides in acute ischaemic stroke. Search methods We searched the Cochrane Stroke Group trials register (last searched: May 2001) and contacted drug companies and main investigators of included trials. Selection criteria Randomised trials […]

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Tirilazad for acute ischaemic stroke

Abstract Background Tirilazad mesylate is neuroprotective in experimental models of ischaemic stroke suggesting it might be of benefit clinically. Objectives To assess whether tirilazad mesylate is safe and effective at improving outcome in patients with acute ischaemic stroke. Search methods Trials of tirilazad were identified from searches of the Cochrane Stroke Group Trials Register (last […]

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Pharmacological treatment for aphasia following stroke

Abstract Background Aphasia describes language impairment associated with a brain lesion. Objectives To assess the effects of drugs on language abilities when given to people with aphasia following stroke. Search methods We searched the Cochrane Stroke Group Trials Register (last searched: May 2001), and reference lists of relevant articles to December 1998. We also contacted […]

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Timing of surgery for aneurysmal subarachnoid haemorrhage

Abstract Background The timing of surgery to secure a ruptured aneurysm after a subarachnoid haemorrhage is an important issue. Early clipping of an aneurysm prevents rebleeding, a major cause of death after a subarachnoid haemorrhage. However, concerns about the possible deleterious effects of early surgery raise questions about the safety and efficacy of this approach. […]

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Eversion versus conventional carotid endarterectomy for preventing stroke

Abstract Background Carotid endarterectomy (CEA) is conventionally undertaken by a longitudinal arteriotomy. Eversion CEA, which employs a transverse arteriotomy and reimplantation of the carotid artery, is reported to be associated with low perioperative stroke and restenosis rates but an increased risk of complications associated with a distal intimal flap. Objectives To determine whether eversion CEA […]

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