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Remote ischaemic conditioning for preventing and treating ischaemic stroke.
CONCLUSIONS: We found low-quality evidence that RIC may reduce the risk of recurrent stroke in participants with intracerebral artery stenosis and reduce stroke severity in participants undergoing carotid stenting, but it may increase death or dependence in participants with acute ischaemic stroke who are undergoing intravenous thrombolysis. However, there is considerable uncertainty about these conclusions because of the small number of studies and low quality of the evidence. PMID: 29974450 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - July 5, 2018 Category: General Medicine Authors: Zhao W, Zhang J, Sadowsky MG, Meng R, Ding Y, Ji X Tags: Cochrane Database Syst Rev Source Type: research

Blood pressure-lowering treatment for preventing recurrent stroke, major vascular events, and dementia in patients with a history of stroke or transient ischaemic attack.
CONCLUSIONS: Our results support the use of BPLDs in people with stroke or TIA for reducing the risk of recurrent stroke. Current evidence is primarily derived from trials studying an ACE inhibitor or a diuretic. No definite conclusions can be drawn from current evidence regarding an optimal systolic blood pressure target after stroke or TIA. PMID: 30024023 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - July 19, 2018 Category: General Medicine Authors: Zonneveld TP, Richard E, Vergouwen MD, Nederkoorn PJ, de Haan R, Roos YB, Kruyt ND Tags: Cochrane Database Syst Rev Source Type: research

Prehospital stroke scales as screening tools for early identification of stroke and transient ischemic attack.
CONCLUSIONS: In the field, CPSS had consistently the highest sensitivity and, therefore, should be preferred to other scales. Further evidence is needed to determine its absolute accuracy and whether alternatives scales, such as MASS and ROSIER, which might have comparable sensitivity but higher specificity, should be used instead, to achieve better overall accuracy. In the ER, ROSIER should be the test of choice, as it was evaluated in more studies than FAST and showed consistently high sensitivity. In a cohort of 100 people of whom 62 have stroke/TIA, the test will miss on average seven people with stroke/TIA (ranging fr...
Source: Cochrane Database of Systematic Reviews - April 8, 2019 Category: General Medicine Authors: Zhelev Z, Walker G, Henschke N, Fridhandler J, Yip S Tags: Cochrane Database Syst Rev Source Type: research

Information provision for stroke survivors and their carers
CONCLUSIONS: Active information provision may improve stroke-survivor knowledge and quality of life, and may reduce anxiety and depression. However, the reductions in anxiety and depression scores were small and may not be important. In contrast, providing information passively may slightly worsen stroke-survivor anxiety and depression scores, although again the importance of this is unclear. Evidence relating to carers and to other outcomes of passive information provision is generally very uncertain. Although the best way to provide information is still unclear, the evidence is better for strategies that actively involve...
Source: Cochrane Database of Systematic Reviews - November 23, 2021 Category: General Medicine Authors: Thomas F Crocker Lesley Brown Natalie Lam Faye Wray Peter Knapp Anne Forster Source Type: research

Antiepileptic drugs for the primary and secondary prevention of seizures after stroke
CONCLUSIONS: There is insufficient evidence to support the routine use of AEDs on the primary and secondary prevention of seizures after stroke. Further well-conducted studies are warranted for this important clinical problem.PMID:35129214 | DOI:10.1002/14651858.CD005398.pub4
Source: Cochrane Database of Systematic Reviews - February 7, 2022 Category: General Medicine Authors: Richard S Chang William Cy Leung Michael Vassallo Lucy Sykes Emma Battersby Wood Joseph Kwan Source Type: research

Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in patients with stroke or transient ischaemic attack.
CONCLUSIONS: PPAR-γ agonists were demonstrated to reduce recurrent stroke and total events of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke, and improve insulin sensitivity and the stabilisation of carotid plaques. There is evidence of limited quality that they are well-tolerated. However, the conclusions should be interpreted with caution considering the small number and the quality of the included studies. In future, well-designed, double-blind RCTs with large samples are required to test the efficacy and safety of PPAR-γ agonists in the secondary prevention of stroke and related vascular ev...
Source: Cochrane Database of Systematic Reviews - January 8, 2014 Category: Journals (General) Authors: Liu J, Wang LN Tags: Cochrane Database Syst Rev Source Type: research

Closure versus medical therapy for preventing recurrent stroke in patients with patent foramen ovale and a history of cryptogenic stroke or transient ischemic attack.
CONCLUSIONS: The combined data from recent RCTs have shown no statistically significant differences between TDC and medical therapy in the prevention of recurrent ischemic stroke. TDC closure was associated with an increased risk of atrial fibrillation but not with serious adverse events. PMID: 26346232 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 8, 2015 Category: Journals (General) Authors: Li J, Liu J, Liu M, Zhang S, Hao Z, Zhang J, Zhang C Tags: Cochrane Database Syst Rev Source Type: research

Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in patients with stroke or transient ischaemic attack.
CONCLUSIONS: PPAR-γ agonists appear to reduce recurrent stroke and total events of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke, and improve insulin sensitivity and the stabilisation of carotid plaques. There is evidence of limited quality that they are well tolerated. However, the conclusions should be interpreted with caution considering the small number and the quality of the included studies. In future, well-designed, double-blind RCTs with large samples are required to assess the efficacy and safety of PPAR-γ agonists in the secondary prevention of stroke and related vascular events in p...
Source: Cochrane Database of Systematic Reviews - October 29, 2015 Category: Journals (General) Authors: Liu J, Wang LN Tags: Cochrane Database Syst Rev Source Type: research

Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in people with stroke or transient ischaemic attack.
CONCLUSIONS: Peroxisome proliferator-activated receptor gamma agonists probably reduce recurrent stroke and total events of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke, and may improve insulin sensitivity and the stabilisation of carotid plaques. Their effects on adverse events are uncertain. Our conclusions should be interpreted with caution considering the small number and the quality of the included studies. Further well-designed, double-blind RCTs with large samples are required to assess the efficacy and safety of PPAR-γ agonists in the secondary prevention of stroke and related vascular...
Source: Cochrane Database of Systematic Reviews - December 2, 2017 Category: General Medicine Authors: Liu J, Wang LN Tags: Cochrane Database Syst Rev Source Type: research

Multiple versus fewer antiplatelet agents for preventing early recurrence after ischaemic stroke or transient ischaemic attack.
CONCLUSIONS: Multiple antiplatelet agents are more effective in reducing stroke recurrence but increase the risk of haemorrhage compared to one antiplatelet agent. The benefit in reduction of stroke recurrence seems to outweigh the harm for dual antiplatelet agents initiated in the acute setting and continued for one month. There is lack of evidence regarding multiple versus multiple antiplatelet agents. Further studies are required in different populations to establish comprehensive safety profiles and long-term outcomes to establish duration of therapy. PMID: 32813275 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - August 16, 2020 Category: General Medicine Authors: Naqvi IA, Kamal AK, Rehman H Tags: Cochrane Database Syst Rev Source Type: research

Transcranial direct current stimulation (tDCS) for improving activities of daily living, and physical and cognitive functioning, in people after stroke.
CONCLUSIONS: There is evidence of very low to moderate quality on the effectiveness of tDCS versus control (sham intervention or any other intervention) for improving ADL outcomes after stroke. However, the results did not persist in a sensitivity analyses including only trials with proper allocation concealment. Evidence of low to high quality suggests that there is no effect of tDCS on arm function and leg function, muscle strength, and cognitive abilities in people after stroke. Evidence of very low quality suggests that there is an effect on hemispatial neglect. There was moderate-quality evidence that adverse events...
Source: Cochrane Database of Systematic Reviews - November 11, 2020 Category: General Medicine Authors: Elsner B, Kugler J, Pohl M, Mehrholz J Tags: Cochrane Database Syst Rev Source Type: research

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