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Type of anaesthesia for acute ischaemic stroke endovascular treatment
CONCLUSIONS: In early outcomes, general anaesthesia improves target artery revascularisation compared to non-general anaesthesia with moderate-certainty evidence. General anaesthesia may improve adverse events (haemodynamic instability) compared to non-general anaesthesia with low-certainty evidence. We found no evidence of a difference in neurological impairment, stroke-related mortality, all intracranial haemorrhage and haemodynamic instability adverse events between groups with low-certainty evidence. We are uncertain whether general anaesthesia improves functional outcomes and time to revascularisation because the cert...
Source: Cochrane Database of Systematic Reviews - July 20, 2022 Category: General Medicine Authors: Renato Tosello Rachel Riera Giuliano Tosello Caroline Nb Clezar Jorge E Amorim Vladimir Vasconcelos Benedito B Joao Ronald Lg Flumignan Source Type: research

Marine-derived n-3 fatty acids therapy for stroke
CONCLUSIONS: We are very uncertain of the effect of marine-derived n-3 PUFAs therapy on functional outcomes and dependence after stroke as there is insufficient high-certainty evidence. More well-designed RCTs are needed, specifically in acute stroke, to determine the efficacy and safety of the intervention. Studies assessing functional outcome might consider starting the intervention as early as possible after the event, as well as using standardised, clinically relevant measures for functional outcomes, such as the modified Rankin Scale. Optimal doses remain to be determined; delivery forms (type of lipid carriers) and m...
Source: Cochrane Database of Systematic Reviews - June 29, 2022 Category: General Medicine Authors: Celia Gabriela Alvarez Campano Mary Joan Macleod Lorna Aucott Frank Thies Source Type: research

Percutaneous transluminal angioplasty and stenting for vertebral artery stenosis
CONCLUSIONS: This Cochrane Review provides low- to moderate-certainty evidence indicating that there are no significant differences in either short- or long-term risks of stroke, death, or TIA between people with symptomatic vertebral artery stenosis treated with ET plus MT and those treated with MT alone.PMID:35579383 | DOI:10.1002/14651858.CD013692.pub2
Source: Cochrane Database of Systematic Reviews - May 17, 2022 Category: General Medicine Authors: Ran Xu Xiao Zhang Sihua Liu Xue Wang Wenjiao Wang Kun Yang Tao Wang Adam A Dmytriw Xuesong Bai Yan Ma Liqun Jiao Bin Yang 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

Oral antiplatelet therapy for acute ischaemic stroke
CONCLUSIONS: Antiplatelet therapy with aspirin 160 mg to 300 mg daily, given orally (or by nasogastric tube or per rectum in people who cannot swallow) and started within 48 hours of onset of presumed ischaemic stroke, significantly decreased death and dependency, and reduced the risk of early recurrent ischaemic stroke without a major risk of early haemorrhagic complications; long-term outcomes were improved.PMID:35028933 | DOI:10.1002/14651858.CD000029.pub4
Source: Cochrane Database of Systematic Reviews - January 14, 2022 Category: General Medicine Authors: Jatinder S Minhas Tamara Chithiramohan Xia Wang Sam C Barnes Rebecca H Clough Meeriam Kadicheeni Lucy C Beishon Thompson Robinson Source Type: research

Intravenous thrombolytic treatment and endovascular thrombectomy for ischaemic wake-up stroke
CONCLUSIONS: In selected patients with acute ischaemic wake-up stroke, both intravenous thrombolytic treatment and endovascular thrombectomy of large vessel occlusion improved functional outcome without increasing the risk of death. However, a possible increased risk of symptomatic intracranial haemorrhage associated with thrombolytic treatment cannot be ruled out. The criteria used for selecting patients to treatment differed between the trials. All studies were relatively small, and six of the seven studies were terminated early. More studies are warranted in order to determine the optimal criteria for selecting patients...
Source: Cochrane Database of Systematic Reviews - December 1, 2021 Category: General Medicine Authors: Melinda B Roaldsen Haakon Lindekleiv Ellisiv B Mathiesen Source Type: research

Interventions for altering blood pressure in people with acute subarachnoid haemorrhage
CONCLUSIONS: Based on the current evidence, there is a lack of information needed to confirm or reject minimally important intervention effects on patient-important outcomes for both induced hypertension and lowered blood pressure. There is an urgent need for trials assessing the effects of altering blood pressure in people with acute subarachnoid haemorrhage. Such trials should use the SPIRIT statement for their design and the CONSORT statement for their reporting. Moreover, such trials should use methods allowing for blinded altering of blood pressure and report on patient-important outcomes such as mortality, rebleeding...
Source: Cochrane Database of Systematic Reviews - November 17, 2021 Category: General Medicine Authors: Mathias Maagaard William K Karlsson Christian Ovesen Christian Gluud Janus C Jakobsen Source Type: research

Anticoagulants for acute ischaemic stroke
CONCLUSIONS: Since the last version of this review, four new relevant studies have been published, and conclusions remain consistent. People who have early anticoagulant therapy after acute ischaemic stroke do not demonstrate any net short- or long-term benefit. Treatment with anticoagulants reduced recurrent stroke, deep vein thrombosis, and pulmonary embolism but increased bleeding risk. Data do not support the routine use of any of the currently available anticoagulants for acute ischaemic stroke.PMID:34676532 | DOI:10.1002/14651858.CD000024.pub5
Source: Cochrane Database of Systematic Reviews - October 22, 2021 Category: General Medicine Authors: Xia Wang Menglu Ouyang Jie Yang Lili Song Min Yang Craig S Anderson Source Type: research

Local versus general anaesthesia for carotid endarterectomy
CONCLUSIONS: The incidence of stroke and death were not convincingly different between local and general anaesthesia for people undergoing carotid endarterectomy. The current evidence supports the choice of either approach. Further high-quality studies are still needed as the evidence is of limited reliability.PMID:34642940 | DOI:10.1002/14651858.CD000126.pub5
Source: Cochrane Database of Systematic Reviews - October 13, 2021 Category: General Medicine Authors: Amaraporn Rerkasem Saritphat Orrapin Dominic Pj Howard Sothida Nantakool Kittipan Rerkasem Source Type: research

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