Cerebrovascular disease

Antifibrinolytic therapy for aneurysmal subarachnoid haemorrhage

Abstract Background Rebleeding is an important cause of death and disability in people with aneurysmal subarachnoid haemorrhage. Rebleeding is probably related to dissolution of the blood clot at the site of aneurysm rupture by natural fibrinolytic activity. This review is an update of a previously published Cochrane review. Objectives To assess the effects of antifibrinolytic […]

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Factor Xa inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in patients with atrial fibrillation

Abstract Background Anticoagulant treatment with vitamin K antagonists (VKAs) is aimed at preventing thromboembolic complications and has been the therapy of choice for most people with non-valvular atrial fibrillation (AF) for many decades. A new class of anticoagulants, the factor Xa inhibitors, appear to have several pharmacological and practical advantages over VKAs. Objectives To assess […]

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Cognitive rehabilitation for spatial neglect following stroke

Abstract Background Unilateral spatial neglect causes difficulty attending to one side of space. Various rehabilitation interventions have been used but evidence of their benefit is lacking. Objectives To assess whether cognitive rehabilitation improves functional independence, neglect (as measured using standardised assessments), destination on discharge, falls, balance, depression/anxiety and quality of life in stroke patients with […]

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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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Anticonvulsants for preventing seizures in patients with chronic subdural haematoma

Abstract Background Anticonvulsant therapy is sometimes used prophylactically in patients with chronic subdural haematoma, although the benefit is unclear. Objectives To assess the effects of prophylactic anticonvulsants in patients with chronic subdural haematoma, in both the pre- and post-operative periods. Search methods We searched the Cochrane Injuries Group’s Specialised Register, CENTRAL (The Cochrane Library), MEDLINE […]

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Occupational therapy for care home residents with stroke

Abstract Background Stroke is a worldwide problem and is a leading cause of adult disability, resulting in dependency in activities of daily living (ADL) for around half of stroke survivors. It is estimated that up to 25% of all care home residents in the USA and in the UK have had a stroke. Stroke survivors who […]

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Multidisciplinary rehabilitation following botulinum toxin and other focal intramuscular treatment for post-stroke spasticity

Abstract Background Spasticity may affect stroke survivors by contributing to activity limitations, caregiver burden, pain and reduced quality of life (QoL). Spasticity management guidelines recommend multidisciplinary (MD) rehabilitation programmes following botulinum toxin (BoNT) treatment for post-stroke spasticity. However, the evidence base for the effectiveness of MD rehabilitation is unclear. Objectives To assess the effectiveness of MD […]

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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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Repetitive transcranial magnetic stimulation for improving function after stroke

Abstract Background It had been assumed that suppressing the undamaged contralesional motor cortex by repetitive low-frequency transcranial magnetic stimulation (rTMS) or increasing the excitability of the damaged hemisphere cortex by high-frequency rTMS will promote function recovery after stroke. Objectives To assess the efficacy and safety of rTMS for improving function in people with stroke. Search […]

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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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