Journal articles: 'Stroke treatments'

1

KOMOTAR, RICARDO J., and E. SANDER CONNOLLY. "Stroke Treatments." Neurosurgery 55, no. 1 (July 2004): N6. http://dx.doi.org/10.1227/01.neu.0000309434.18777.e1.

Full text

APA, Harvard, Vancouver, ISO, and other styles

2

Beresford, Isabel JM, Andrew A. Parsons, and A. Jacqueline Hunter. "Treatments for stroke." Expert Opinion on Emerging Drugs 8, no. 1 (May 2003): 103–22. http://dx.doi.org/10.1517/14728214.8.1.103.

Full text

APA, Harvard, Vancouver, ISO, and other styles

3

Haast, Roy AM, Deborah R. Gustafson, and Amanda J. Kiliaan. "Sex Differences in Stroke." Journal of Cerebral Blood Flow & Metabolism 32, no. 12 (October 3, 2012): 2100–2107. http://dx.doi.org/10.1038/jcbfm.2012.141.

Full text

Abstract:

Sex differences in stroke are observed across epidemiologic studies, pathophysiology, treatments, and outcomes. These sex differences have profound implications for effective prevention and treatment and are the focus of this review. Epidemiologic studies reveal a clear age-by-sex interaction in stroke prevalence, incidence, and mortality. While premenopausal women experience fewer strokes than men of comparable age, stroke rates increase among postmenopausal women compared with age-matched men. This postmenopausal phenomenon, in combination with living longer, are reasons for women being older at stroke onset and suffering more severe strokes. Thus, a primary focus of stroke prevention has been based on sex steroid hormone-dependent mechanisms. Sex hormones affect different (patho)physiologic functions of the cerebral circulation. Clarifying the impact of sex hormones on cerebral vasculature using suitable animal models is essential to elucidate male–female differences in stroke pathophysiology and development of sex-specific treatments. Much remains to be learned about sex differences in stroke as anatomic and genetic factors may also contribute, revealing its multifactorial nature. In addition, the aftermath of stroke appears to be more adverse in women than in men, again based on older age at stroke onset, longer prehospital delays, and potentially, differences in treatment.

APA, Harvard, Vancouver, ISO, and other styles

4

Aguiar de Sousa, Diana, Rascha von Martial, Sònia Abilleira, Thomas Gattringer, Adam Kobayashi, Miquel Gallofré, Franz Fazekas, et al. "Access to and delivery of acute ischaemic stroke treatments: A survey of national scientific societies and stroke experts in 44 European countries." European Stroke Journal 4, no. 1 (July 20, 2018): 13–28. http://dx.doi.org/10.1177/2396987318786023.

Full text

Abstract:

Introduction Acute stroke unit care, intravenous thrombolysis and endovascular treatment significantly improve the outcome for patients with ischaemic stroke, but data on access and delivery throughout Europe are lacking. We assessed best available data on access and delivery of acute stroke unit care, intravenous thrombolysis and endovascular treatment throughout Europe. Methods A survey, drafted by stroke professionals (ESO, ESMINT, EAN) and a patient organisation (SAFE), was sent to national stroke societies and experts in 51 European countries (World Health Organization definition) requesting experts to provide national data on stroke unit, intravenous thrombolysis and endovascular treatment rates. We compared both pooled and individual national data per one million inhabitants and per 1000 annual incident ischaemic strokes with highest country rates. Population estimates were based on United Nations data, stroke incidences on the Global Burden of Disease Report. Results We obtained data from 44 European countries. The estimated mean number of stroke units was 2.9 per million inhabitants (95% CI 2.3–3.6) and 1.5 per 1000 annual incident strokes (95% CI 1.1–1.9), highest country rates were 9.2 and 5.8. Intravenous thrombolysis was provided in 42/44 countries. The estimated mean annual number of intravenous thrombolysis was 142.0 per million inhabitants (95% CI 107.4–176.7) and 72.7 per 1000 annual incident strokes (95% CI 54.2–91.2), highest country rates were 412.2 and 205.5. Endovascular treatment was provided in 40/44 countries. The estimated mean annual number of endovascular treatments was 37.1 per million inhabitants (95% CI 26.7–47.5) and 19.3 per 1000 annual incident strokes (95% CI 13.5–25.1), highest country rates were 111.5 and 55.9. Overall, 7.3% of incident ischaemic stroke patients received intravenous thrombolysis (95% CI 5.4–9.1) and 1.9% received endovascular treatment (95% CI 1.3–2.5), highest country rates were 20.6% and 5.6%. Conclusion We observed major inequalities in acute stroke treatment between and within 44 European countries. Our data will assist decision makers implementing tailored stroke care programmes for reducing stroke-related morbidity and mortality in Europe.

APA, Harvard, Vancouver, ISO, and other styles

5

del Zoppo, Gregory. "Antithrombotic Treatments in Acute Ischemic Stroke." Thrombosis and Haemostasis 82, no. 08 (1999): 938–46. http://dx.doi.org/10.1055/s-0037-1615936.

Full text

Abstract:

IntroductionStroke may be defined as a syndrome of thrombohemorrhagic disorders affecting the central nervous system. In this setting, considerable efforts have been directed to improve clinical outcome with antithrombotic agents, including platelet inhibitors, anticoagulants, and plasminogen activators. The search for a role for antithrombotic agents in ischemic stroke rests on the observation that, overall, 75% to 80% of strokes involve thrombotic events. Recent experience with plasminogen activators (PAs) in acute ischemic stroke indicates that, in select patients, clinical improvement is associated with shorter interval from symptom onset to treatment, while clinically significant hemorrhagic transformation increases with delays in treatment. The time-dependence and the subpopulation characteristics of outcomes following PA exposure is entirely compatible with an evolution of brain injury and varies individually, but where microvascular integrity in the ischemic bed decreases with time. These relationships have not been developed or explored with other antithrombotic agents, including antiplatelet agents or anticoagulants. Thus, among antithrombotic agents, only certain PAs have been used in a strictly “acute” setting, that is within 6 to 8 hours of symptom onset. This presentation summarizes current experience with antithrombotic interventions in focal cerebral ischemia in the acute and early (>8) hours following symptom onset.

APA, Harvard, Vancouver, ISO, and other styles

6

Filipska, Karolina, Adam Wiśniewski, and Robert Ślusarz. "Thrombolysis and Mechanical Thrombectomy as Leading Treatments for Acute Ischemic Stroke." Journal of Neurological and Neurosurgical Nursing 8, no. 4 (December 2019): 177–81. http://dx.doi.org/10.15225/pnn.2019.8.4.6.

Full text

Abstract:

Brain vascular diseases, especially strokes, are still a very serious public health and medicine problem. The world is still facing an epidemic of stroke. With the impact load increasing all over the world, there is a continuing need to understand the characteristics of this disease and its impact in different countries. Despite significant improvements in primary prevention and treatment efficacy over the past decades, stroke is still a debilitating disease. Early treatment is the key to successful recovery of patients with ischemic stroke. The aim of the study is to show the most effective methods of treating patients in the acute phase of ischemic stroke. (JNNN 2019;8(4):177–181) Key Words: ischemic stroke, treatment, thrombolysis, thrombectomy

APA, Harvard, Vancouver, ISO, and other styles

7

Al-Senani, Fahmi, Mohammed Al-Johani, Mohammad Salawati, Souda ElSheikh, Maha AlQahtani, Jamal Muthana, Saeed AlZahrani, et al. "A national economic and clinical model for ischemic stroke care development in Saudi Arabia: A call for change." International Journal of Stroke 14, no. 8 (May 23, 2019): 835–42. http://dx.doi.org/10.1177/1747493019851284.

Full text

Abstract:

Background Stroke is a significant burden in Saudi Arabia and the Saudi Ministry of Health's stroke committee has identified an urgent need to improve care. Aim The purpose of this study was to undertake a health-economic analysis to quantify the impact of developing stroke care in the country. Methods An economic model was developed to assess the costs and clinical outcomes associated with an ischemic stroke care development program compared with current stroke care. Based on Saudi epidemiological data, cohorts of ischemic stroke patients enter the model each year for the first 10 years based on increasing incidence. Four treatment options were modeled including reperfusion and non-reperfusion treatments. The development scenario estimates the impact of gradually increasing uptake of more effective treatments over 10 years. Changes in the stroke care organization are considered along with resources required to increase capacity, allowing more patients to be admitted to stroke hospitals and access effective treatments. Results The stroke care development program is associated with an increase in functionally independent patients and a decrease in disabling strokes compared with current stroke care. Additionally, the development program is associated with estimated cost savings of $602 million over 15 years ($255 million direct costs, $348 million indirect costs). Conclusions The model predicts that the stroke care development program is associated with improved patient outcomes and lower overall costs compared with the current stroke care program.

APA, Harvard, Vancouver, ISO, and other styles

8

ZOLER, MITCHEL L. "Intraarterial Treatments Target Acute Stroke." Internal Medicine News 38, no. 22 (November 2005): 35. http://dx.doi.org/10.1016/s1097-8690(05)72366-0.

Full text

APA, Harvard, Vancouver, ISO, and other styles

9

Schehr, Robert S. "New treatments for acute stroke." Nature Biotechnology 14, no. 11 (November 1996): 1549–54. http://dx.doi.org/10.1038/nbt1196-1549.

Full text

APA, Harvard, Vancouver, ISO, and other styles

10

Markus, Hugh S. "Current treatments in neurology: Stroke." Journal of Neurology 252, no. 3 (March 2005): 260–67. http://dx.doi.org/10.1007/s00415-005-0736-9.

Full text

APA, Harvard, Vancouver, ISO, and other styles

11

Della-Morte, David, Fiorella Guadagni, Raffaele Palmirotta, Gianluca Testa, Valeria Caso, Maurizio Paciaroni, Pasquale Abete, et al. "Genetics of ischemic stroke, stroke-related risk factors, stroke precursors and treatments." Pharmacogenomics 13, no. 5 (April 2012): 595–613. http://dx.doi.org/10.2217/pgs.12.14.

Full text

APA, Harvard, Vancouver, ISO, and other styles

12

Bernardo-Castro, Sara, Inês Albino, Ángela María Barrera-Sandoval, Francesca Tomatis, João André Sousa, Emanuel Martins, Susana Simões, Miguel M. Lino, Lino Ferreira, and João Sargento-Freitas. "Therapeutic Nanoparticles for the Different Phases of Ischemic Stroke." Life 11, no. 6 (May 26, 2021): 482. http://dx.doi.org/10.3390/life11060482.

Full text

Abstract:

Stroke represents the second leading cause of mortality and morbidity worldwide. Ischemic strokes are the most prevalent type of stroke, and they are characterized by a series of pathological events prompted by an arterial occlusion that leads to a heterogeneous pathophysiological response through different hemodynamic phases, namely the hyperacute, acute, subacute, and chronic phases. Stroke treatment is highly reliant on recanalization therapies, which are limited to only a subset of patients due to their narrow therapeutic window; hence, there is a huge need for new stroke treatments. Nonetheless, the vast majority of promising treatments are not effective in the clinical setting due to their inability to cross the blood-brain barrier and reach the brain. In this context, nanotechnology-based approaches such as nanoparticle drug delivery emerge as the most promising option. In this review, we will discuss the current status of nanotechnology in the setting of stroke, focusing on the diverse available nanoparticle approaches targeted to the different pathological and physiological repair mechanisms involved in each of the stroke phases.

APA, Harvard, Vancouver, ISO, and other styles

13

Casaubon, Leanne, Peter McLaughlin, Gary Webb, Erik Yeo, Darren Merker, and Cheryl Jaigobin. "Recurrent Stroke/TIA in Cryptogenic Stroke Patients with Patent Foramen Ovale." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 34, no. 1 (February 2007): 74–80. http://dx.doi.org/10.1017/s0317167100005825.

Full text

Abstract:

Background:Patent foramen ovale (PFO) is present in 40% of patients with cryptogenic stroke and may be associated with paradoxical emboli to the brain. Therapeutic options include antiplatelet agents, anticoagulation, percutaneous device and surgical closure. We assessed the hypothesis that there are differences in rates of recurrent TIA or stroke between patients in the four treatment groups.Methods:Patients presenting from January 1997 with cryptogenic stroke or TIA and PFO were followed prospectively until June 2003. Treatment choice was made on an individual case basis. The primary outcome was recurrent stroke. The secondary outcome was a composite of stroke, TIA, and vascular death.Results:Baseline. Our cohort consisted of 121 patients; 64 (53%) were men. Median age was 43 years. Sixty-nine percent presented with stroke and 31% with TIA. One or more vascular risk factor was present in 40%. Atrial septal aneurysm (ASA) was present in 24%. Treatment consisted of antiplatelet agents (34%), anticoagulation (17%), device (39%) and surgical closure (11%). Follow-up. Recurrent events occurred in 16 patients (9 antiplatelet, 3 anticoagulation, 4 device closure); 7 were strokes, 9 were TIA. Comparing individual treatments there was a trend toward more strokes in the antiplatelet arm (p=0.072); a significant difference was seen for the composite endpoint (p=0.012). Comparing closure versus combined medical therapy groups, a significant difference was seen for primary (p=0.014) and secondary (p=0.008) outcomes, favoring closure. Age and pre-study event predicted outcome.Conclusion:Patent foramen ovale closure was associated with fewer recurrent events. Complications of surgical and device closure were self-limited.

APA, Harvard, Vancouver, ISO, and other styles

14

Savastano, Luis, Joseph J. Gemmete, Aditya S. Pandey, Christopher Roark, and Neeraj Chaudhary. "Republished: Acute ischemic stroke in a child due to basilar artery occlusion treated successfully with a stent retriever." Journal of NeuroInterventional Surgery 8, no. 8 (July 8, 2015): e33-e33. http://dx.doi.org/10.1136/neurintsurg-2015-011821.rep.

Full text

Abstract:

Ischemic strokes in childhood are rare. Thrombolytic therapy with intravenous (IV) tissue plasminogen activator (tPA) has been the main intervention for the management of pediatric stroke patients, but safety data are lacking and efficacy has been questioned. Recently, successful endovascular treatments for acute ischemic stroke in children have been reported with increasing frequency, suggesting that mechanical thrombectomy can be a safe and effective treatment. We present the case of a 22-month-old child with acute ischemic stroke due to basilar artery occlusion that was successfully treated with a stent retriever.

APA, Harvard, Vancouver, ISO, and other styles

15

Jeong, Han-Yeong, Keun-Hwa Jung, Heejung Mo, Chan-Hyuk Lee, Tae Jung Kim, Jong-Moo Park, MiSun Oh, et al. "Characteristics and management of stroke in Korea: 2014–2018 data from Korean Stroke Registry." International Journal of Stroke 15, no. 6 (October 22, 2019): 619–26. http://dx.doi.org/10.1177/1747493019884517.

Full text

Abstract:

Background Lifestyle changes and evolving healthcare practices in Korea have influenced disease patterns and medical care. Since strokes have high disease burden in countries with aging populations, it is necessary to evaluate the associated recent disease characteristics and patient care patterns. The Korean Stroke Registry is a nationwide, multicenter, prospective, hospital-based stroke registry in Korea used to monitor these changes across the population. Aims We aimed to evaluate the recent status of clinical characteristics and management of stroke cases in order to identify changes in the Korean population across time. Methods This study used Korean Stroke Registry data from patients experiencing ischemic stroke or transient ischemic attack patients, between 2014 and 2018. We analyzed data on demographics, risk factors, stroke subtypes, and treatments that included thrombolysis. Results A total of 39,291 patients (mean age 68.0 ± 13.0, 58.3% male) were analyzed. The proportions of hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, and prior stroke were 63.4%, 30.9%, 27.7%, 19.4%, and 17.1%, respectively. In the stroke subtype analysis, the frequency of large artery atherosclerosis was highest (32.6%), followed by cardioembolism (21.3%) and small vessel occlusion (19.9%). Acute reperfusion therapy was conducted in 15.3% of cases (11.7% using intravenous tPA and 7.3% using intra-arterial thrombectomy). Intra-arterial thrombectomy also demonstrated a steep increasing trend over time (RR 1.095 (1.060–1.131), p < 0.001). Conclusions This study provided analysis of nationwide, hospital-based, quality-controlled data from the Korean Stroke Registry database regarding changes in the characteristics, risk factors, and treatments of strokes in Korea.

APA, Harvard, Vancouver, ISO, and other styles

16

Li, William A., Shannon Moore-Langston, Tia Chakraborty, Jose A. Rafols, Alana C. Conti, and Yuchuan Ding. "Hyperglycemia in stroke and possible treatments." Neurological Research 35, no. 5 (June 2013): 479–91. http://dx.doi.org/10.1179/1743132813y.0000000209.

Full text

APA, Harvard, Vancouver, ISO, and other styles

17

Khaja, Aslam M., and James C. Grotta. "Established treatments for acute ischaemic stroke." Lancet 369, no. 9558 (January 2007): 319–30. http://dx.doi.org/10.1016/s0140-6736(07)60154-8.

Full text

APA, Harvard, Vancouver, ISO, and other styles

18

Sacco, Ralph L., Ji Y. Chong, Shyam Prabhakaran, and Mitchell SV Elkind. "Experimental treatments for acute ischaemic stroke." Lancet 369, no. 9558 (January 2007): 331–41. http://dx.doi.org/10.1016/s0140-6736(07)60155-x.

Full text

APA, Harvard, Vancouver, ISO, and other styles

19

Samama, M. M., P. C. Desnoyers, J. Conard, and M. G. Bousser. "Acute Ischemic Stroke and Heparin Treatments." Thrombosis and Haemostasis 78, no. 01 (1997): 173–79. http://dx.doi.org/10.1055/s-0038-1657521.

Full text

APA, Harvard, Vancouver, ISO, and other styles

20

Zerna, Charlotte, Janka Hegedus, and Michael D. Hill. "Evolving Treatments for Acute Ischemic Stroke." Circulation Research 118, no. 9 (April 29, 2016): 1425–42. http://dx.doi.org/10.1161/circresaha.116.307005.

Full text

APA, Harvard, Vancouver, ISO, and other styles

21

del Zoppo, Gregory J. "Antithrombotic treatments in acute ischemic stroke." Current Opinion in Hematology 7, no. 5 (September 2000): 309–15. http://dx.doi.org/10.1097/00062752-200009000-00009.

Full text

APA, Harvard, Vancouver, ISO, and other styles

22

O'Collins, Victoria E., Malcolm R. Macleod, Geoffrey A. Donnan, Laura L. Horky, Bart H. van der Worp, and David W. Howells. "1,026 Experimental treatments in acute stroke." Annals of Neurology 59, no. 3 (March 2006): 467–77. http://dx.doi.org/10.1002/ana.20741.

Full text

APA, Harvard, Vancouver, ISO, and other styles

23

Ferguson, James J. "New Treatments for Acute Ischemic Stroke." Circulation 93, no. 9 (May 1996): 1604. http://dx.doi.org/10.1161/01.cir.93.9.1604.

Full text

APA, Harvard, Vancouver, ISO, and other styles

24

Dawson, J., and M. Walters. "New and emerging treatments for stroke." British Medical Bulletin 77-78, no. 1 (September 11, 2006): 87–102. http://dx.doi.org/10.1093/bmb/ldl011.

Full text

APA, Harvard, Vancouver, ISO, and other styles

25

Koroshetz, Walter J., and Michael A. Moskowitz. "Emerging treatments for stroke in humans." Trends in Pharmacological Sciences 17, no. 6 (June 1996): 227–33. http://dx.doi.org/10.1016/0165-6147(96)10020-1.

Full text

APA, Harvard, Vancouver, ISO, and other styles

26

Schneck, Michael J., and José Biller. "New treatments in acute ischemic stroke." Current Treatment Options in Neurology 7, no. 6 (December 2005): 499–511. http://dx.doi.org/10.1007/s11940-005-0050-y.

Full text

APA, Harvard, Vancouver, ISO, and other styles

27

Blass, John. "Clinical trials of treatments for stroke." Current Atherosclerosis Reports 4, no. 4 (July 2002): 265–69. http://dx.doi.org/10.1007/s11883-002-0004-8.

Full text

APA, Harvard, Vancouver, ISO, and other styles

28

Yi, Yoon Young, Hyo Jung Shin, Seung Gyu Choi, Joon Won Kang, Hee-Jung Song, Sung Koo Kim, and Dong Woon Kim. "Preventive Effects of Neuroprotective Agents in a Neonatal Rat of Photothrombotic Stroke Model." International Journal of Molecular Sciences 21, no. 10 (May 24, 2020): 3703. http://dx.doi.org/10.3390/ijms21103703.

Full text

Abstract:

Neonatal ischemic stroke has a higher incidence than childhood stroke. Seizures are the first sign for the need for clinical assessment in neonates, but many questions remain regarding treatments and follow-up modalities. In the absence of a known pathophysiological mechanism, only supportive care is currently provided. Stroke-induced microglia activation and neuroinflammation are believed to play a central role in the pathological progression of neonatal ischemic stroke. We induced a photothrombotic infarction with Rose Bengal in neonatal rats to investigate the effects of pre- and post-treatment with Aspirin (ASA), Clopidogrel (Clop), and Coenzyme Q10 (CoQ10), which are known for their neuroprotective effects in adult stroke. Pre-stroke medication ameliorates cerebral ischemic injury and reduces infarct volume by reducing microglia activation, cellular reactive oxygen species (ROS) production, and cytokine release. Post-stroke administration of ASA, Clop, and CoQ10 increased motor function and reduced the volume of infarction, and the statistical evidence was stronger than that seen in the pre-stroke treatment. In this study, we demonstrated that ASA, Clop, and CoQ10 treatment before and after the stroke reduced the scope of stroke lesions and increased behavioral activity. It suggests that ASA, Clop, and CoQ10 medication could significantly have neuroprotective effects in the neonates who have suffered strokes.

APA, Harvard, Vancouver, ISO, and other styles

29

Kim, Seung Min, Jin-Man Jung, Bum Joon Kim, Ji-Sung Lee, and Sun U. Kwon. "Cilostazol Mono and Combination Treatments in Ischemic Stroke." Stroke 50, no. 12 (December 2019): 3503–11. http://dx.doi.org/10.1161/strokeaha.119.026655.

Full text

Abstract:

Background and Purpose— We performed a systematic review and meta-analysis to explore the efficacy and safety of cilostazol as a mono or combination (plus aspirin or clopidogrel) treatments compared to conventional single antiplatelet therapy (SAPT, mainly aspirin) for secondary stroke prevention. Methods— Randomized controlled trial studies were searched across multiple comprehensive databases (MEDLINE, EMBASE, and Cochrane) for review. The primary outcome was recurrent stroke comprising ischemic and hemorrhagic stroke. Secondary outcomes included ischemic stroke, hemorrhagic stroke, myocardial infarction, and composite outcomes. We performed an updated systematic review and meta-analysis of the identified reports, including 2 recently published randomized controlled trials. In addition, network meta-analysis was performed to compare the relative effects of mono versus combination cilostazol treatments. Results— Ten studies were included in this review, 5 of which were assigned to the cilostazol mono group (n=5429) and the other 5 to the combination group (n=2456). The relative risks of recurrent stroke, ischemic stroke, and composite outcomes with cilostazol mono as well as combination treatments were significantly lower than with SAPT without any significant heterogeneity. An indirect comparison of these 3 outcomes revealed the cilostazol combination approach to be superior. The cilostazol mono treatment diminished hemorrhagic stroke more significantly than SAPT and the cilostazol combination did not increase hemorrhagic stroke compared to SAPT. The outcomes from the 2 cilostazol regimens were comparable to SAPT in the case of myocardial infarction. Conclusions— Cilostazol is a more effective and safer treatment option than SAPT approaches using mainly aspirin. Cilostazol regimens can also be modified to clinical situations as this drug reduces recurrent and ischemic stroke more efficiently as a combination therapy but is more beneficial for hemorrhagic stroke as a monotherapy.

APA, Harvard, Vancouver, ISO, and other styles

30

Saadi, Altaf. "Black patients missing out on stroke treatmentAbout stroke and its treatments." Neurology 90, no. 5 (January 29, 2018): e444-e446. http://dx.doi.org/10.1212/wnl.0000000000004904.

Full text

APA, Harvard, Vancouver, ISO, and other styles

31

Fagan, Susan C. "Stroke Management." Journal of Pharmacy Practice 6, no. 6 (December 1993): 297–303. http://dx.doi.org/10.1177/089719009300600607.

Full text

Abstract:

With as many as 500,000 new strokes per year in the United States, the need for safe and effective therapy of these patients is evident. The area in which the greatest impact has been made is in the development of prophylactic treatments for patients at risk of stroke. Aspirin, long the mainstay of stroke management, has repeatedly been shown to reduce the risk of cerebral ischemia in patients who have had a transient ischemic attack (TIA) or minor stroke and is first-line therapy for these patients. Either 325 mg or 975 mg of aspirin may be used. Ticlopidine (250 mg twice daily) is a new antiplatelet agent that is recommended for the prophylaxis of stroke in patients who cannot tolerate or who are resistant to aspirin therapy. The surgical procedure, carotid endarterectomy, has been shown to reduce the stroke rate in symptomatic patients, with between 70% to 99% stenosis of a carotid artery. The use of warfarin has been shown to be extremely useful in patients with atrial fibrillation for prevention of recurrent embolic events. The use of pharmacological agents in the acute treatment of the ischemic stroke patient has not yet been proven successful. It is hoped that with the trend towards hyperacute (less than 6 hours) intervention, investigators may be successful in finding an agent to decrease the ultimate neurological deficit due to stroke. Some of the more promising agents are thrombolytics, glutamate antagonists, and aminosteroids. Future research in cerebral ischemia will undoubtedly improve the prognosis of stroke patients.

APA, Harvard, Vancouver, ISO, and other styles

32

Brainin, Michael, and Natan Bornstein. "Experimental and Clinical Approaches to Recovery after Stroke." European Neurological Review 10, no. 01 (2015): 65. http://dx.doi.org/10.17925/enr.2015.10.01.65.

Full text

Abstract:

The development of effective treatments that aid recovery after stroke has been hampered in recent decades by a lack of knowledge regarding stroke complexity and the processes involved in neurological repair. Many stroke treatments tested so far have been monomodal, targeting only one neurobiological process whereas multimodal treatments are more likely to address the complex processes of stroke recovery. Understanding of stroke recovery, however, is increasing using imaging techniques, especially positron emission tomography (PET). This reveals features such as the tissue at risk in the peri-infarct area, which can be functionally restored if treatment is initiated rapidly. Understanding of stroke risk is also improving with the use of biomarkers. A promising approach to stroke therapy is non-invasive brain stimulation (NIBS), which can precisely target specific functional areas of the cortex. Clinical studies indicate that NIBS provides improvements in motor functions and aphasia but more supporting evidence is needed. When treating stroke it is critically important to take account of co-morbidities, such as diabetes and hypertension, since these have profound effects on outcomes. The provision of adequate rehabilitation soon after stroke is critical for optimal recovery and should include drug therapy. Such interventions at local treatment centres, however, are often under-resourced. Current developments are leading to a better understanding of pathophysiology and improved awareness of risks and treatments should, in future, also improve rehabilitation and hence benefit outcomes following a stroke.

APA, Harvard, Vancouver, ISO, and other styles

33

D'Souza, Caitlin E., Melanie R. F. Greenway, Jonathan Graff-Radford, and James F. Meschia. "Cognitive Impairment in Patients with Stroke." Seminars in Neurology 41, no. 01 (January 8, 2021): 075–84. http://dx.doi.org/10.1055/s-0040-1722217.

Full text

Abstract:

AbstractDespite substantial advances in stroke care, vascular cognitive impairment remains a prominent source of disability. Unlike sensorimotor impairments, cognition often continues to decline after stroke. An aging population will increase the prevalence of vascular cognitive impairment, with stroke playing an important role. Ten percent of patients presenting with stroke have pre-stroke dementia; an additional 10% will develop incident dementia with a first stroke, and 30% with a recurrent stroke. While stroke increases the risk of cognitive impairment, the presence of cognitive impairment also impacts acute stroke treatment and increases risk of poor outcome by nearly twofold. There is substantial overlap in the clinical and pathological aspects of vascular and degenerative dementias in many patients. How they relate to one another is controversial. The treatment of vascular cognitive impairment remains supportive, focusing on treating vascular risk factors. Cognitive rehabilitation after stroke is an area of active research, and existing pharmacologic treatments have limited benefit. Heightened awareness of cognitive impairment in the setting of stroke is imperative for prognostication and management, impetus for research and, ultimately, the discovery of efficacious treatments.

APA, Harvard, Vancouver, ISO, and other styles

34

Prabhakaran, Shyam, Steven R. Messé, Dawn Kleindorfer, Eric E. Smith, Gregg C. Fonarow, Haolin Xu, Xin Zhao, Barbara Lytle, Joaquin Cigarroa, and Lee H. Schwamm. "Cryptogenic stroke." Neurology: Clinical Practice 10, no. 5 (September 26, 2019): 396–405. http://dx.doi.org/10.1212/cpj.0000000000000736.

Full text

Abstract:

BackgroundNationwide data on patients with cryptogenic stroke (CS) are lacking. We evaluated patient and hospital characteristics, in-hospital treatments, and discharge outcomes among patients with CS compared with other subtypes in the Get With The Guidelines (GWTG)-Stroke registry.MethodsWe identified patients with ischemic stroke (IS) admitted to GWTG-Stroke participating hospitals between January 1, 2016, and September 30, 2017, with documented National Institutes of Health Stroke Scale (NIHSS) scale and stroke etiology (cardioembolic [CE], large artery atherosclerosis [LAA], small vessel occlusion [SVO], other determined etiology [OTH], or CS). Using multivariable logistic regression, we compared hospital treatments and discharge outcomes by subtype, adjusted for patient and hospital characteristics.ResultsAmong 316,623 patients from 1,687 hospitals, there were 63,301 (20.0%) patients with CS. In multivariable analysis, patients with CS received IV thrombolysis more often than other subtypes and had lower mortality than CE, LAA, and OTH but higher mortality than SVO. They were more likely to be discharged home than all other subtypes and be independent at discharge than LAA, OTH, or SVO.ConclusionsIn a large contemporary nationwide registry, CS accounted for 20% of ISs among patients with a documented stroke etiology. Patients with CS had a distinct profile of treatments and outcomes relative to other subtypes. Improved subtype documentation and further research into CS are warranted to improve care and outcomes for patients with stroke.

APA, Harvard, Vancouver, ISO, and other styles

35

Rambaud, Thomas, Nicolas Legris, Yannick Bejot, Céline Bellesme, Bertrand Lapergue, Eric Jouvent, Fernando Pico, et al. "Acute ischemic stroke in adolescents." Neurology 94, no. 2 (December 12, 2019): e158-e169. http://dx.doi.org/10.1212/wnl.0000000000008783.

Full text

Abstract:

ObjectiveAdolescence represents a transition period between childhood and adulthood, and only limited information exists about stroke characteristics in this population. Our aim was to describe the clinical and neuroradiologic features, etiologies, initial management, and outcome of ischemic stroke in adolescents.MethodsThis retrospective cohort study evaluated all consecutive patients 10 to 18 years with a first-ever ischemic stroke hospitalized between 2007 and 2017 in 10 French academic centers representing a population of ≈10 million. Extracted data from the national database served as validation.ResultsA total of 60 patients were included (53% male, median age 15.2 years). Diagnosis at first medical contact was misevaluated in 36%, more frequently in posterior than anterior circulation strokes (55% vs 20% respectively, odds ratio 4.8, 95% confidence interval 1.41–16.40, p = 0.01). Recanalization treatment rate was high (n = 19, 32%): IV thrombolysis (17%), endovascular therapy (11.7%), or both IV and intra-arterial thrombolysis (3.3%); safety was good (only 1 asymptomatic hemorrhagic transformation). Despite thorough etiologic workup, 50% of strokes remained cryptogenic. The most common determined etiologies were cardioembolism (15%), vasculitis and autoimmune disorders (12%, occurring exclusively in female patients), and arterial dissections (10%, exclusively in male patients). Recurrent ischemic cerebrovascular events occurred in 12% (median follow-up 19 months). Recurrence rate was 50% in patients with identified vasculopathy but 0% after cryptogenic stroke. Functional outcome was favorable (Rankin Scale score 0–2 at day 90) in 80% of cases.ConclusionsIschemic strokes in adolescents harbor both pediatric and adult features, emphasizing the need for multidisciplinary collaboration in their management. Recanalization treatments appear feasible and safe.

APA, Harvard, Vancouver, ISO, and other styles

36

Meyding-Lamadé, U., B. Bassa, E. Craemer, C. Jacobi, C. Chan, W. Hacke, and B. Kress. "Setting up a Neuroscience Stroke and Rehabilitation Centre in Brunei Darussalam by a transcontinental on-site and telemedical cooperation." International Journal of Stroke 12, no. 2 (November 24, 2016): 132–36. http://dx.doi.org/10.1177/1747493016672086.

Full text

Abstract:

Due to the world-wide aging population, there is a need for specialist neurological knowledge, treatment and care. Stroke treatment is effective in reducing mortality and disability, but it is still not available in many areas of the world. We describe the set-up process of a specialized Neuroscience, Stroke and Rehabilitation Centre in Brunei Darussalam (BNSRC) in cooperation with a German hospital. This study details the setup of a stroke-, neurological intensive care- and neurorehabilitation unit, laboratories and a telemedical network to perform all evidence-based stroke treatments. All neurological on-site services and the telemedical network were successfully established within a short time. After setup, 1386 inpatients and 1803 outpatients with stroke and stroke mimics were treated. All evidence-based stroke treatments including thrombolysis and hemicraniectomy could be performed. It is possible to establish evidence-based modern stroke treatment within a short time period by a transcontinental on-site and telemedical cooperation.

APA, Harvard, Vancouver, ISO, and other styles

37

Kahle, Michael P., and Gregory J. Bix. "Successfully Climbing the “STAIRs”: Surmounting Failed Translation of Experimental Ischemic Stroke Treatments." Stroke Research and Treatment 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/374098.

Full text

Abstract:

The Stroke Therapy Academic Industry Roundtable (STAIR) provided initial (in 1999) and updated (in 2009) recommendations with the goal of improving preclinical stroke therapy assessment and to increase the translational potential of experimental stroke treatments. It is important for preclinical stroke researchers to frequently consider and revisit these concepts, especially since promising experimental stroke treatments continue to fail in human clinical trials. Therefore, this paper will focus on considerations for several key aspects of preclinical stroke studies including the selection and execution of the animal stroke model, drug/experimental treatment administration, and outcome measures to improve experimental validity and translation potential. Specific points of interest discussed include the incorporation of human comorbid conditions and drugs, the benefits of defining a proposed mechanism of action, replication of results using multiple methods, using clinically relevant routes of administration and treatment time windows, and performing and reporting good experimental methods to reduce bias such as, as suggested by the updated STAIR recommendations, sample size calculations, randomization, allocation concealment, blinding, and appropriate inclusion/exclusion criteria. It is our hope that reviewing and revisiting these considerations will benefit researchers in their investigations of stroke therapies and increase the likelihood of translational success in the battle against stroke.

APA, Harvard, Vancouver, ISO, and other styles

38

Cramer, Steven C. "Treatments to Promote Neural Repair after Stroke." Journal of Stroke 20, no. 1 (January 31, 2018): 57–70. http://dx.doi.org/10.5853/jos.2017.02796.

Full text

APA, Harvard, Vancouver, ISO, and other styles

39

Sandercock, P. "Important new treatments for acute ischaemic stroke?" BMJ 295, no. 6608 (November 14, 1987): 1224–25. http://dx.doi.org/10.1136/bmj.295.6608.1224.

Full text

APA, Harvard, Vancouver, ISO, and other styles

40

Claflin, Edward S., Chandramouli Krishnan, and Sandeep P. Khot. "Emerging Treatments for Motor Rehabilitation After Stroke." Neurohospitalist 5, no. 2 (December 2014): 77–88. http://dx.doi.org/10.1177/1941874414561023.

Full text

APA, Harvard, Vancouver, ISO, and other styles

41

Wilson, Anne. "Pharmacological treatments for stroke prevention in AF." British Journal of Cardiac Nursing 8, no. 12 (December 2013): 580–87. http://dx.doi.org/10.12968/bjca.2013.8.12.580.

Full text

APA, Harvard, Vancouver, ISO, and other styles

42

Frithz, G. "Important new treatments for acute ischaemic stroke?" BMJ 296, no. 6616 (January 16, 1988): 211. http://dx.doi.org/10.1136/bmj.296.6616.211-a.

Full text

APA, Harvard, Vancouver, ISO, and other styles

43

Lin, David J., Seth P. Finklestein, and Steven C. Cramer. "New Directions in Treatments Targeting Stroke Recovery." Stroke 49, no. 12 (December 2018): 3107–14. http://dx.doi.org/10.1161/strokeaha.118.021359.

Full text

APA, Harvard, Vancouver, ISO, and other styles

44

George, Paul M., and Gary K. Steinberg. "Novel Stroke Therapeutics: Unraveling Stroke Pathophysiology and Its Impact on Clinical Treatments." Neuron 87, no. 2 (July 2015): 297–309. http://dx.doi.org/10.1016/j.neuron.2015.05.041.

Full text

APA, Harvard, Vancouver, ISO, and other styles

45

Hsuan, Yogi Chang-Yo, Cheng-Hsien Lin, Ching-Ping Chang, and Mao-Tsun Lin. "Mesenchymal stem cell-based treatments for stroke, neural trauma, and heat stroke." Brain and Behavior 6, no. 10 (August 3, 2016): e00526. http://dx.doi.org/10.1002/brb3.526.

Full text

APA, Harvard, Vancouver, ISO, and other styles

46

Kim, Yerim, Dae Young Yoon, Jee-Eun Kim, Ju-Hun Lee, Hong-Ki Song, and Jong Seok Bae. "Historical diagnostic and therapeutic changes of ischemic stroke based on the highly cited articles." Science Editing 7, no. 2 (August 20, 2020): 156–62. http://dx.doi.org/10.6087/kcse.211.

Full text

Abstract:

Purpose: Stroke is a global economic burden of health, which means that it is critical to evaluate changes of optimal diagnoses and treatments. The aim of the study reported herein was to identify the most-cited articles in the field of ischemic stroke and assess their characteristics. Methods: We searched all included articles that had been cited more than 100 times using the “Cited Reference Search” in February 2016 from Web of Science Core Collection. Among a total of 2,651 articles, we excluded articles on basic science and which involved only hemorrhagic strokes and identified the top-100 cited articles on ischemic stroke. Results: The number of citations for the articles analyzed in this study ranged from 5,182 to 580. Most of the articles were published in The Lancet (25%) and Stroke (23%), and originated from the United States of America (n=44). Most of them were original articles (65%) and dealt with stroke risk factors (32%) and stroke management (30%). A novel study of hyperacute treatment involving recombinant-tissue plasminogen activator was described in the top-ranked article. Conclusion: Reviews on highly cited articles can help physicians identify trends in the diagnosis and treatment of ischemic stroke in the past. This bibliometric analysis can provide a unique perspective on historical developments in this field.

APA, Harvard, Vancouver, ISO, and other styles

47

Bacigaluppi, Marco, and Dirk M. Hermann. "New Targets of Neuroprotection in Ischemic Stroke." Scientific World JOURNAL 8 (2008): 698–712. http://dx.doi.org/10.1100/tsw.2008.94.

Full text

Abstract:

Ischemic stroke represents one of the most challenging diseases in translational neurology. Despite the considerable efforts made to develop efficacious therapies that prevent damage once a stroke has occurred, there are still no established treatments for humans. The only available treatment is intravenous or intra-arterial thrombolysis that is limited to the very first hours after the stroke. Starting with recent findings about the pathophysiology of stroke and presenting an overview on current experimental models of this clinically highly relevant neurological disease, this paper will provide an overview on existing and emerging treatment concepts in ischemic stroke. Thus, our review will present an analysis of established and innovative strategies of neuroprotection and neurorestoration, highlighting both pharmacological and cell-based treatment concepts. In the last section of our paper, we will examine more closely how experimental data are presently translated to humans, with particular emphasis on the bioaccumulation and efficacy of drugs. From this point of view, we will try to develop ideas of how causative treatments in ischemic stroke may be established.

APA, Harvard, Vancouver, ISO, and other styles

48

Iwamuro, Y., I. Nakahara, T. Higashi, M. Iwaasa, Y. Watanabe, K. Tsunetoshi, T. Munemitsu, and M. Taha. "Result of Neck Clipping and Coil Embolization as a Treatment for Unruptured Aneurysm." Interventional Neuroradiology 13, no. 1_suppl (March 2007): 151–56. http://dx.doi.org/10.1177/15910199070130s123.

Full text

Abstract:

The report of the International Subarachnoid Aneurysm Trial (ISAT) study showed that coil embolization was superior to neck clipping as a treatment for subarachnoid hemorrhage (SAH) 1. Recently, some results of treatments for unruptured aneurysm via coil embolization and neck clipping have been reported2,3. We compared the results of coil embolization and neck clipping in our institute. Generally better outcomes were obtained by endovascular surgery than by neck clipping. Postoperative ischemic strokes occurred in one case (1.8%) as a major stroke and in three cases (5.6%) as a minor stroke among coil-treated cases, and in two cases(2.6%) as a major stroke, and in seven cases(9.0%) as a minor stroke among neck clipping cases. Other complications after these treatments were six cases of subdural effusion/hematoma, four cases of infection, two cases of epidural hematoma, one abducens nerve palsy, one hydrocephalus, and one acute myocardial infarction among 78 neck clipping cases, and two subcutaneous hematoma, one pseudoaneurysm at the puncture points, one direct carotid-cavernous fistula among 54 coil-treated cases. Four coil-treated cases, in which introduction of microcatheters to the aneurysm was impossible, were treated completely by neck clipping after endovascular treatments. In terms of modified Rankin Scale(mRS) three months after treatments, while mRS 3 was noted in only one case in the endovascular treatment group, there were one case of mRS 3, two cases of mRS 4, and two cases of mRS 5 in the neck clipping group. Duration of hospitalization averaged 11.9 days in the endovascular group and 24.1 days in the neck clipping group. The results of endosaccular enbolizations as treatment of the unruptured aneurysm seems to be better than neck clipping. However, not all cases of unruptured aneurysms can be treated by coil embolization due to the width of aneurysmal neck and relation of the aneurysm to parent arteries. Therefore, surgeons should also be able to perform neck clipping as an alternative modality.

APA, Harvard, Vancouver, ISO, and other styles

49

Regenhardt, Robert W., Maijo R. Biseko, Agness F. Shayo, Theoflo N. Mmbando, Sara J. Grundy, Ai Xu, Altaf Saadi, et al. "Opportunities for intervention: stroke treatments, disability and mortality in urban Tanzania." International Journal for Quality in Health Care 31, no. 5 (August 28, 2018): 385–92. http://dx.doi.org/10.1093/intqhc/mzy188.

Full text

Abstract:

AbstractObjectiveGiven the high post-stroke mortality and disability and paucity of data on the quality of stroke care in Sub-Saharan Africa, we sought to characterize the implementation of stroke-focused treatments and 90-day outcomes of neuroimaging-confirmed stroke patients at the largest referral hospital in Tanzania.DesignProspective cohort study.SettingMuhimbili National Hospital (MNH) in Dar es Salaam, July 2016–March 2017.ParticipantsAdults with new-onset stroke (<14 days), confirmed by head CT, admitted to MNH.Main outcomes measuresModified Rankin scale (mRS) and vital status.ResultsOf 149 subjects (mean age 57; 48% female; median NIH stroke scale (NIHSS) 19; 46% ischemic stroke; 54% hemorrhagic), implementation of treatments included: dysphagia screening (80%), deep venous thrombosis prophylaxis (0%), aspirin (83%), antihypertensives (89%) and statins (95%). There was limited ability to detect atrial fibrillation and carotid artery disease and no acute thrombolysis or thrombectomy. Of ischemic subjects, 19% died and 56% had severe disability (mRS 4–5) at discharge; 49% died by 90 days. Of hemorrhagic subjects, 33% died and 49% had severe disability at discharge; 50% died by 90 days. In a multivariable model, higher NIHSS score but not dysphagia, unconsciousness, or patient age was predictive of death by 90 days.ConclusionsThe 90-day mortality of stroke presenting at MNH is 50%, much higher than in higher income settings. Although severe stroke presentations are a major factor, efforts to improve the quality of care and prevent complications of stroke are urgently needed. Acute stroke interventions with low number needed to treat represent challenging long-term goals.

APA, Harvard, Vancouver, ISO, and other styles

50

Keir, SL, and K. Strachan. "Stroke medicine for the geriatrician 2010." Reviews in Clinical Gerontology 20, no. 2 (April 29, 2010): 92–104. http://dx.doi.org/10.1017/s0959259810000122.

Full text

Abstract:

SummaryThis review explores the recent advances in investigation and treatment of acute stroke, as well as its secondary prevention, with emphasis on the relevance of the evidence for the older population. Hyperacute reperfusion treatment is becoming increasingly embedded into the day-to-day management of stroke and trials are ongoing that will help determine its safety in the older patient. Managing all stroke patients in a stroke unit is known to improve outcome and recent work has helped to inform care decisions. Application of the robust data available on secondary prevention treatments may have to be weighed alongside the degree of frailty of the patient for whom treatment is being considered.

APA, Harvard, Vancouver, ISO, and other styles

Journal articles on the topic 'Stroke treatments'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles