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Source: The Lancet Neurology
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Total 249 results found since Jan 2013.
Effects of long-term blood pressure lowering and dual antiplatelet treatment on cognitive function in patients with recent lacunar stroke: a secondary analysis from the SPS3 randomised trial
Publication date: December 2014 Source:The Lancet Neurology, Volume 13, Issue 12 Author(s): Lesly A Pearce , Leslie A McClure , David C Anderson , Claudia Jacova , Mukul Sharma , Robert G Hart , Oscar R Benavente Background The primary outcome results for the SPS3 trial suggested that a lower systolic target blood pressure (<130 mm Hg) might be beneficial for reducing the risk of recurrent stroke compared with a higher target (130–149 mm Hg), but that the addition of clopidogrel to aspirin was not beneficial compared with aspirin plus placebo. In this prespecified secondary outcome analysis of the SPS3 trial, we...
Source: The Lancet Neurology - December 8, 2014 Category: Neurology Source Type: research
Endovascular stent thrombectomy: the new standard of care for large vessel ischaemic stroke
Publication date: Available online 25 June 2015 Source:The Lancet Neurology Author(s): Bruce C V Campbell , Geoffrey A Donnan , Kennedy R Lees , Werner Hacke , Pooja Khatri , Michael D Hill , Mayank Goyal , Peter J Mitchell , Jeffrey L Saver , Hans-Christoph Diener , Stephen M Davis Background Results of initial randomised trials of endovascular treatment for ischaemic stroke, published in 2013, were neutral but limited by the selection criteria used, early-generation devices with modest efficacy, non-consecutive enrolment, and treatment delays. Recent developments In the past year, six positive trials of endovascular t...
Source: The Lancet Neurology - June 26, 2015 Category: Neurology Source Type: research
Home-based constraint-induced movement therapy for patients with upper limb dysfunction after stroke (HOMECIMT): a cluster-randomised, controlled trial
Publication date: Available online 28 July 2015 Source:The Lancet Neurology Author(s): Anne Barzel, Gesche Ketels, Anne Stark, Britta Tetzlaff, Anne Daubmann, Karl Wegscheider, Hendrik van den Bussche, Martin Scherer Background Constraint-induced movement therapy (CIMT) is recommended for patients with upper limb dysfunction after stroke, yet evidence to support the implementation of CIMT in ambulatory care is insufficient. We assessed the efficacy of home CIMT, a modified form of CIMT that trains arm use in daily activities within the home environment. Methods In this parallel, cluster-randomised controlled tri...
Source: The Lancet Neurology - July 30, 2015 Category: Neurology Source Type: research
Effect of baseline Alberta Stroke Program Early CT Score on safety and efficacy of intra-arterial treatment: a subgroup analysis of a randomised phase 3 trial (MR CLEAN)
We examined the effect of the baseline Alberta Stroke Program Early CT Score (ASPECTS) on the safety and efficacy of intra-arterial treatment in a subgroup analysis of the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN). Methods MR CLEAN was a randomised, controlled, open-label, phase 3 trial of intra-arterial treatment in patients (aged ≥18 years from the Netherlands) with proximal arterial occlusion of the anterior circulation, given intra-arterial treatment within 6 h of stroke onset. The primary outcome was 90 day modified Rankin Scale (mRS) sco...
Source: The Lancet Neurology - May 11, 2016 Category: Neurology Source Type: research
Neuroprotection in acute stroke: targeting excitotoxicity, oxidative and nitrosative stress, and inflammation
Publication date: Available online 11 May 2016 Source:The Lancet Neurology Author(s): Ángel Chamorro, Ulrich Dirnagl, Xabier Urra, Anna M Planas Treatments for acute ischaemic stroke continue to evolve after the superior value of endovascular thrombectomy was confirmed over systemic thrombolysis. Unfortunately, numerous neuroprotective drugs have failed to show benefit in the treatment of acute ischaemic stroke, making the search for new treatments imperative. Increased awareness of the relevance of rigorous preclinical testing, and appropriate selection of study participants, might overcome the barriers to progress...
Source: The Lancet Neurology - May 11, 2016 Category: Neurology Source Type: research
B vitamins in stroke prevention: time to reconsider
Publication date: September 2017 Source:The Lancet Neurology, Volume 16, Issue 9 Author(s): J David Spence, Qilong Yi, Graeme J Hankey B vitamin therapy lowers plasma total homocysteine concentrations, and might be a beneficial intervention for stroke prevention; however, cyanocobalamin (a form of vitamin B12) can accelerate decline in renal function and increase the risk of cardiovascular events in patients with impaired renal function. Although early trials did not show benefit in reduction of stroke, these results might have been due to harm in participants with impaired renal function. In patients with diabetic nephro...
Source: The Lancet Neurology - August 9, 2017 Category: Neurology Source Type: research
Cerebral microbleeds and intracranial haemorrhage risk in patients anticoagulated for atrial fibrillation after acute ischaemic stroke or transient ischaemic attack (CROMIS-2): a multicentre observational cohort study
This study is registered with ClinicalTrials.gov, number NCT02513316. Findings Between Aug 4, 2011, and July 31, 2015, we recruited 1490 participants of whom follow-up data were available for 1447 (97%), over a mean period of 850 days (SD 373; 3366 patient-years). The symptomatic intracranial haemorrhage rate in patients with cerebral microbleeds was 9·8 per 1000 patient-years (95% CI 4·0–20·3) compared with 2·6 per 1000 patient-years (95% CI 1·1–5·4) in those without cerebral microbleeds (adjusted hazard ratio 3·67, 95% CI 1·27–10·60). Compared with the HAS-BLED score alone (C-index 0·41, 95% CI 0·29–0...
Source: The Lancet Neurology - May 16, 2018 Category: Neurology Source Type: research
Imaging biomarkers of vulnerable carotid plaques for stroke risk prediction and their potential clinical implications
Publication date: Available online 4 April 2019Source: The Lancet NeurologyAuthor(s): Luca Saba, Tobias Saam, H Rolf Jäger, Chun Yuan, Thomas S Hatsukami, David Saloner, Bruce A Wasserman, Leo H Bonati, Max WintermarkSummaryStroke represents a massive public health problem. Carotid atherosclerosis plays a fundamental part in the occurence of ischaemic stroke. European and US guidelines for prevention of stroke in patients with carotid plaques are based on quantification of the percentage reduction in luminal diameter due to the atherosclerotic process to select the best therapeutic approach. However, better strategies for...
Source: The Lancet Neurology - April 4, 2019 Category: Neurology Source Type: research
Global brain inflammation in stroke
Publication date: Available online 8 July 2019Source: The Lancet NeurologyAuthor(s): Kaibin Shi, De-Cai Tian, Zhi-Guo Li, Andrew F Ducruet, Michael T Lawton, Fu-Dong ShiSummaryStroke, including acute ischaemic stroke and intracerebral haemorrhage, results in neuronal cell death and the release of factors such as damage-associated molecular patterns (DAMPs) that elicit localised inflammation in the injured brain region. Such focal brain inflammation aggravates secondary brain injury by exacerbating blood–brain barrier damage, microvascular failure, brain oedema, oxidative stress, and by directly inducing neuronal cell dea...
Source: The Lancet Neurology - July 10, 2019 Category: Neurology Source Type: research
Effect of intermittent pneumatic compression on disability, living circumstances, quality of life, and hospital costs after stroke: secondary analyses from CLOTS 3, a randomised trial
Publication date: December 2014 Source:The Lancet Neurology, Volume 13, Issue 12 Background The results of the CLOTS 3 trial showed that intermittent pneumatic compression (IPC) reduced the risk of deep vein thrombosis and improved survival in immobile patients with stroke. IPC is now being widely used in stroke units. Here we describe the disability, living circumstances, quality of life, and hospital costs of patients in CLOTS 3. Methods In CLOTS 3, a parallel group trial in 94 UK hospitals, immobile patients with stroke from days 0 to 3 of admission were assigned with a computer-generated allocation sequence in a 1:1 r...
Source: The Lancet Neurology - December 8, 2014 Category: Neurology Source Type: research
Safety and efficacy of thrombectomy in acute ischaemic stroke (REVASCAT): 1-year follow-up of a randomised open-label trial
We report the results of the prespecified 12-month analysis of the REVASCAT trial. Methods Patients with acute ischaemic stroke who could be treated within 8 h of symptom onset were randomly assigned to medical therapy (including intravenous alteplase when eligible) and neurovascular thrombectomy with Solitaire FR or medical therapy alone. The main secondary outcome measure at 1 year follow-up was disability, measured using the modified Rankin Scale (mRS), ranging from 0 (no symptoms) to 6 (death) with categories 5 (severe disability) and 6 (death) collapsed into one category (severe disability or death), analysed as the d...
Source: The Lancet Neurology - March 16, 2017 Category: Neurology Source Type: research
Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data
Publication date: January 2018 Source:The Lancet Neurology, Volume 17, Issue 1 Author(s): Bruce C V Campbell, Wim H van Zwam, Mayank Goyal, Bijoy K Menon, Diederik W J Dippel, Andrew M Demchuk, Serge Bracard, Philip White, Antoni Dávalos, Charles B L M Majoie, Aad van der Lugt, Gary A Ford, Natalia Pérez de la Ossa, Michael Kelly, Romain Bourcier, Geoffrey A Donnan, Yvo B W E M Roos, Oh Young Bang, Raul G Nogueira, Thomas G Devlin, Lucie A van den Berg, Frédéric Clarençon, Paul Burns, Jeffrey Carpenter, Olvert A Berkhemer, Dileep R Yavagal, Vitor Mendes Pereira, Xavier Ducrocq, Anand Dixit, Helena Quesada, Jonathan E...
Source: The Lancet Neurology - December 16, 2017 Category: Neurology Source Type: research
Constraint-induced movement therapy after stroke
Publication date: February 2015 Source:The Lancet Neurology, Volume 14, Issue 2 Author(s): Gert Kwakkel , Janne M Veerbeek , Erwin E H van Wegen , Steven L Wolf Constraint-induced movement therapy (CIMT) was developed to overcome upper limb impairments after stroke and is the most investigated intervention for the rehabilitation of patients. Original CIMT includes constraining of the non-paretic arm and task-oriented training. Modified versions also apply constraining of the non-paretic arm, but not as intensive as original CIMT. Behavioural strategies are mostly absent for both modified and original CIMT. With forced us...
Source: The Lancet Neurology - January 12, 2015 Category: Neurology Source Type: research
