Stroke; a journal of cerebral circulation
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Randomized Controlled Trial
Cluster randomized pilot controlled trial of an occupational therapy intervention for residents with stroke in UK care homes.
A pilot evaluation of an occupational therapy intervention to improve self-care independence for residents with stroke-related disability living in care homes was the basis of this study. ⋯ Residents who received an occupational therapy intervention were less likely to deteriorate in their ability to perform activities of daily living.
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Randomized Controlled Trial
Randomized controlled trial of acetylsalicylic acid in aneurysmal subarachnoid hemorrhage: the MASH Study.
A previous systematic review of randomized trials suggested a positive effect of antiplatelet therapy in patients with aneurysmal subarachnoid hemorrhage (SAH). We performed a randomized controlled trial to assess whether acetylsalicylic acid (ASA) reduces the risk of delayed ischemic neurological deficit (DIND) in patients with SAH. ⋯ ASA given after aneurysm treatment does not appreciably reduce the occurrence of DIND.
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Convincing evidence of a causal relationship between sleep apnea and stroke has been shown recently in several prospective, well-designed studies. However, these studies have focused on middle-aged people, excluding the elderly population from analysis. To investigate whether sleep apnea represents an independent risk factor in this population, we performed a prospective longitudinal study in a population-based cohort of subjects from 70 to 100 years old. ⋯ This study shows that severe obstructive sleep apnea hypopnea (defined as apnea-hypopnea index >or=30) increases the risk of ischemic stroke in the elderly population, independent of known confounding factors.
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Although tandem internal carotid artery/middle cerebral artery (MCA; TIM) occlusion has been associated with low recanalization rate after IV tissue plasminogen activator (tPA), its independent contribution on stroke outcome remains unknown. Moreover, whether the relative resistance to thrombolysis in tandem lesions varies depending on the location of MCA clot remains uncertain. ⋯ TIM occlusion independently predicts poor outcome after IV thrombolysis. However, its impact varies depending on the location of MCA clot. Therefore, emergent carotid ultrasound plus TCD examinations may improve the selection of patients for more aggressive reperfusion strategies.