According to an epidemiological study of
cerebrovascular disease carried out in China in 1986, the prevalence, incidence, and mortality rates were 159.93/100,000, 115.61/100,000, and 31.33/100,000, respectively. These figures were high compared to available epidemiological data for the rest of the world. This highlights the fact that, as in other countries, functional rehabilitation after
stroke is an important medical and social need in China. Clinical experience shows that within a few hours to a few months after a
stroke, a large proportion of patients spontaneously experience partial, or on occasion, complete recovery from
neurologic symptoms. However, functional rehabilitation in medical care units is required because it assists in and accelerates the recovery of impaired function.
Almitrine-raubasine has been used to improve functional rehabilitation after
stroke for some time in China. By enriching the
oxygen content of arterial blood, it brings more
oxygen to the cerebral tissues and therefore promotes cerebral aerobic metabolism during
ischemia. In the acute phase of
stroke, positron emission tomography showed, in man, that
almitrine-raubasine helps normalize the ischemic penumbra area, as shown by an improvement in the coupling between oxygenation and perfusion. Long after
stroke, single photon emission computed tomography showed that
almitrine-raubasine restores normal cerebral
vasodilator response to
acetazolamide. With a view to further documenting the clinical efficacy of
almitrine-raubasine on the convalescent period of patients with
cerebrovascular disease, a double-blind, placebo-controlled study is planned. One hundred patients with ischemic
cerebrovascular disease in the territory of the carotid artery will be included 4-6 weeks after the acute onset. Two
tablets daily of
almitrine-raubasine or placebo will be prescribed for 3-6 months. Before treatment, there will be a 2-week washout period for all other drugs, except for
antihypertensive and
antidiabetic drugs. In addition to complete clinical monthly examinations, neurological functional deficit scores, Barthel index, Hasagawa
Dementia scales, and CT scan are scheduled. The study results should confirm those reported in the scientific literature: although untreated patients may show spontaneous improvement,
almitrine-raubasine should accelerate patients' functional rehabilitation.