Gamma aminobutyric acid (GABA) receptor agonists for acute stroke
Abstract Background Gamma aminobutyric acid (GABA) receptor agonists have been shown to have a neuroprotectant effect in reducing infarct size and improving functional outcome in animal models of cerebral ischemia. However, the sedation effects of GABA receptor agonists have limited their wider application in acute stroke patients due to the potential risk of stupor. Objectives […]
Thrombolysis for acute ischaemic stroke
Abstract Background Most strokes are due to blockage of an artery in the brain by a blood clot. Prompt treatment with thrombolytic drugs can restore blood flow before major brain damage has occurred and improve recovery after stroke in some people. Thrombolytic drugs, however, can also cause serious bleeding in the brain, which can be […]
Routine or selective carotid artery shunting for carotid endarterectomy (and different methods of monitoring in selective shunting)
Abstract Background Temporary interruption of cerebral blood flow during carotid endarterectomy can be avoided by using a shunt across the clamped section of the carotid artery. This may improve outcome. This is an update of a Cochrane review originally published in 1996 and previously updated in 2009. Objectives To assess the effect of routine versus […]
Interventions for improving sit-to-stand ability following stroke
Abstract Background Standing up from a seated position is one of the most frequently performed functional tasks, is an essential pre-requisite to walking and is important for independent living and preventing falls. Following stroke, patients can experience a number of problems relating to the ability to sit-to-stand independently. Objectives To review the evidence of effectiveness […]
Vitamin K for improved anticoagulation control in patients receiving warfarin
Abstract Background Effective use of warfarin involves keeping the international normalised ratio (INR) within a relatively narrow therapeutic range. However, patients respond widely to their dose of warfarin. Overcoagulation can lead to an increased risk of excessive bleeding, while undercoagulation can lead to increased clot formation. There is some evidence that patients with a variable […]
Interventions for improving modifiable risk factor control in the secondary prevention of stroke
Abstract Background People with stroke or transient ischaemic attack (TIA) are at increased risk of future stroke and other cardiovascular events. Evidence-based strategies for secondary stroke prevention have been established. However, the implementation of prevention strategies could be improved. Objectives To assess the effects of stroke service interventions for implementing secondary stroke prevention strategies on […]
Direct thrombin inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in people with non-valvular atrial fibrillation
Abstract Background Chronic anticoagulation with vitamin K antagonists (VKAs) prevents ischaemic stroke and systemic embolism in people with non-valvular atrial fibrillation (AF) but dose adjustment, coagulation monitoring and bleeding limits its use. Direct thrombin inhibitors (DTIs) are under investigation as potential alternatives. Objectives To assess (1) the comparative efficacy of long-term anticoagulation using DTIs versus […]
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 […]
Rehabilitation for improving automobile driving after stroke
Abstract Background Interventions to improve driving ability after stroke, including driving simulation and retraining visual skills, have limited evaluation of their effectiveness to guide policy and practice. Objectives To determine whether any intervention, with the specific aim of maximising driving skills, improves the driving performance of people after stroke. Search methods We searched the Cochrane […]
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 […]