Ischaemic

Glycoprotein IIb-IIIa inhibitors for acute ischaemic stroke

Abstract Background Glycoprotein (GP) IIb-IIIa inhibitors are antiplatelet agents that act by antagonising GP IIb-IIIa receptors on the platelet surface and block the final common pathway to platelet aggregation by preventing the binding of fibrinogen molecules that form bridges between adjacent platelets. Thus, GP IIb-IIIa inhibitors could favour endogenous thrombolysis by reducing thrombus growth and […]

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Insulin for glycaemic control in acute ischaemic stroke

Abstract Background People with hyperglycaemia concomitant with an acute stroke have greater mortality, stroke severity, and functional impairment when compared with those with normoglycaemia at stroke presentation. This is an update of a Cochrane Review first published in 2011. Objectives To determine whether intensively monitoring insulin therapy aimed at maintaining serum glucose within a specific […]

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Colony stimulating factors (including erythropoietin, granulocyte colony stimulating factor and analogues) for stroke

Abstract Background Colony stimulating factors (CSFs), also called haematopoietic growth factors, regulate bone marrow production of circulating red and white cells, and platelets. Some CSFs also mobilise the release of bone marrow stem cells into the circulation. CSFs have been shown to be neuroprotective in experimental stroke. Objectives To assess (1) the safety and efficacy […]

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Continuous versus intermittent physiological monitoring for acute stroke

Abstract Background Explanations for the effectiveness of stroke units compared with general wards in reducing mortality, institutionalisation and dependence of people with stroke remain undetermined, and the discussion on the most effective stroke unit model is still up for debate. The intensity of non-invasive mechanical monitoring in many western countries is one of the main […]

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Thrombolysis (different doses, routes of administration and agents) for acute ischaemic stroke

Abstract Background Stroke is a leading cause of death and disability world wide. Thrombolysis with recombinant tissue plasminogen activator (rt-PA) is licensed for treatment of acute ischaemic stroke in the early hours after symptom onset. It has been shown in randomised controlled trials (RCTs) and the 2009 Cochrane review of thrombolysis for acute ischaemic stroke […]

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Sonothrombolysis for acute ischaemic stroke

Abstract Background Sonothrombolysis is a promising but unproven tool for treating acute ischaemic stroke. There is an ongoing debate about the efficacy, safety, technical aspects of ultrasound administration and the possible potentiating effect of microbubbles. Objectives To assess the effectiveness and safety of sonothrombolysis in patients with acute ischaemic stroke. Search methods We searched the […]

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Piracetam for acute ischaemic stroke

Abstract Background Piracetam has neuroprotective and antithrombotic effects that may help to reduce death and disability in people with acute stroke. This is an update of a Cochrane Review first published in 1999, and previously updated in 2006 and 2009. Objectives To assess the effects of piracetam in acute, presumed ischaemic stroke. Search methods We […]

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Vitamin K antagonists versus antiplatelet therapy after transient ischaemic attack or minor ischaemic stroke of presumed arterial origin

Abstract Background People who have had a transient ischaemic attack (TIA) or non-disabling ischaemic stroke have an annual risk of major vascular events of between 4% and 11%. Aspirin reduces this risk by 20% at most. Secondary prevention trials after myocardial infarction indicate that treatment with vitamin K antagonists is associated with a risk reduction […]

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Fibrinogen depleting agents for acute ischaemic stroke

Abstract Background Fibrinogen depleting agents reduce fibrinogen in blood plasma, reduce blood viscosity and hence increase blood flow. This may help remove the blood clot blocking the artery and re-establish blood flow to the affected area of the brain after an ischaemic stroke. The risk of haemorrhage may be less than with thrombolytic agents. This […]

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External counterpulsation for acute ischaemic stroke

Abstract Background External counterpulsation (ECP) may improve cerebral blood flow, and it has been proposed as a potential therapy for patients with ischaemic stroke. Objectives To assess the efficacy and safety of ECP for acute ischaemic stroke. Search methods We searched the Cochrane Stroke Group Trials Register (June 2011), Cochrane Central Register of Controlled Trials […]

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