Stroke; a journal of cerebral circulation
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Clinical Trial Controlled Clinical Trial
Cerebral hemodynamics and metabolism in patients with symptomatic occlusion of the internal carotid artery.
The goals of this study were to investigate (1) whether the concentrations of choline, creatine, and N-acetyl aspartate (NAA) in cerebral white matter are changed in patients with symptomatic occlusion of the internal carotid artery (ICA) and (2) whether possible changes in metabolite concentration are related to regional cerebral perfusion or cerebral vasoreactivity. ⋯ Patients with symptomatic ICA occlusion may show chronic neuronal damage in cerebral white matter as evidenced by reduced NAA concentration. This seems to be related to previous symptomatology rather than to the cerebral hemodynamic status in a chronic stage.
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Numerous studies indicate that mild hypothermia provides substantial neuroprotection. However, current systems transfer insufficient heat to rapidly vary core temperature. We thus evaluated the safety and efficacy of endovascular cooling and rewarming for the induction and reversal of hypothermia. ⋯ The endovascular heat-exchange system effectively cooled and rewarmed pigs with large thermal mass without producing any adverse effects on blood elements, blood vessel integrity, or cardiovascular function.
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Giving stroke victims who reside outside communities with hospitals that can administer tissue plasminogen activator (rtPA) access to thrombolytic therapy is a challenge. Helicopter transport to a stroke center is a potential way to make rtPA available to these communities. We examined the experience of the Shands-Jacksonville Acute Stroke Transport Program, a field-to-stroke center helicopter transport program that serves rural counties in the northeastern Florida/southeastern Georgia region. ⋯ A helicopter-based transport system can link a rural region to a stroke center and promote access to thrombolytic therapy.
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Very limited longitudinal data are available that assess the health-related quality of life (HRQOL) of stroke survivors after discharge from inpatient rehabilitation. The purpose of this research was to assess changes in HRQOL during inpatient rehabilitation and again 6 months after discharge. ⋯ Substantial gains in HRQOL during inpatient stroke rehabilitation may be followed by equally substantial declines in the 6 months after discharge. There is a need for longitudinal research into the HRQOL of stroke survivors and their families, as well as a need to ensure that adequate community services and support are available.
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Randomized Controlled Trial Clinical Trial
Hyperbaric oxygen therapy in acute ischemic stroke: results of the Hyperbaric Oxygen in Acute Ischemic Stroke Trial Pilot Study.
Hyperbaric oxygen therapy (HBO) has promise as a treatment for acute stroke. This study was conducted to evaluate the efficacy, safety, and feasibility of using HBO in acute ischemic stroke. ⋯ Although our HBO protocol appears feasible and safe, it does not appear to be beneficial and may be harmful in patients with acute ischemic stroke.