References
Cerebral Infarction (Ischaemic Stroke) - Related Resources
Cochrane reviews
Pharmacotherapy
- Fibrinogen depleting agents reduce stroke recurrence in acute ischaemic stroke, but they can also cause serious intracranial bleeding Fibrinogen-Depleting Agents for Acute Ischaemic Stroke.
- Aspirin (160 to 300 mg/day) started within 48 hours of onset of presumed ischaemic stroke reduces the risk of early recurrent stroke and improves long-term outcome Antiplatelet Therapy for Acute Ischaemic Stroke.
- Calcium antagonists are not beneficial for patients with acute ischaemic stroke Calcium Antagonists for Stroke.
- Immediate anticoagulant therapy in patients with acute ischaemic stroke is not associated with net short- or long-term benefit Anticoagulants for Acute Ischaemic Stroke.
- Corticosteroids are probably not effective in the treatment of acute presumed ischaemic stroke Corticosteroids for Acute Ischaemic Stroke.
- Naftidrofuryl is not effective in the treatment of acute ischaemic or haemorrhagic stroke Naftidrofuryl for Acute Stroke.
- Piracetam is not beneficial in the treatment of acute stroke Piracetam for Acute Stroke.
- Beta receptor antagonists, calcium channel blockers, nitric oxide, and prostacyclin lower BP in acute stroke. However, these data do not allow the effect of changing BP on outcome to be assessed Vasoactive Drugs for Acute Ischaemic Stroke.
- In ischaemic stroke intra-arterial thrombolysis appears to result in higher rates of recanalisation than non-thrombolytic standard care, translating into improved functional outcome at 3-month follow-up, despite increased rate of symptomatic intracranial haemorrhages Percutaneous Vascular Interventions for Acute Ischaemic Stroke.
- Preventive antibiotic therapy may reduce the risk of infection in patients with acute ischaemic stroke, but may not reduce the number of dependent or deceased patients Antibiotic Therapy for Preventing Infections in Patients with Acute Stroke.
- GABA receptor agonists (chlormethiazole or diazepam) appear not to be effective for the treatment of acute ischemic or hemorrhagic stroke Gamma Aminobutyric Acid (Gaba) Receptor Agonists for Acute Stroke.
- Atenolol may not reduce the risk of stroke, heart attack, or death from vascular disease after ischaemic stroke or transient ischaemic attack (TIA) Atenolol for Preventing Stroke Recurrence.
- Continuous monitoring of physiological variables within 3 days of stroke might possibly improve outcomes and prevent complications, but the evidence is insufficient Continuous Vs. Intermittent Physiological Monitoring for Acute Stroke.
- In acute stroke, higher doses of thrombolytic agents might possibly lead to higher rates of bleeding and intra-arterial treatment might possibly not be more beneficial than intravenous, although the evidence is insufficient Thrombolysis (Different Doses, Routes of Administration and Agents) for Acute Ischaemic Stroke.
- There is no randomised evidence to determine whether, for patients with carotid artery dissection, either antiplatelet or anticoagulant therapy is superior to control, or whether anticoagulant is superior to antiplatelet therapy Antithrombotic Drugs for Carotid Dissection.
- Colony stimulating factors appear not to be effective in the treatment of recent stroke. There appears to be significant safety concerns regarding EPO therapyColony Stimulating Factors Including Erythropoietin (EPO), Granulocyte Colony Stimulating Factor (G-CSF) and Analogues for Stroke.
Literature
- Donnan GA, Fisher M, Macleod M, Davis SM. Stroke. Lancet 2008 May 10;371(9624):1612-23. [PubMed]
- Hankey GJ. Clinical update: management of stroke. Lancet 2007 Apr 21;369(9570):1330-2. [PubMed]
- van der Worp HB, van Gijn J. Clinical practice. Acute ischemic stroke. N Engl J Med 2007 Aug 9;357(6):572-9. [PubMed]