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Stroke (Strokes)

A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)

Also Known As:

Strokes; Apoplexy; Stroke, Acute; Acute Stroke; Stroke, Cerebral; CVA (Cerebrovascular Accident); Cerebrovascular Accident, Acute; Cerebrovascular Stroke; Acute Cerebrovascular Accident; Acute Cerebrovascular Accidents; Acute Strokes; Apoplexy, Cerebrovascular; Brain Vascular Accident; Brain Vascular Accidents; CVAs (Cerebrovascular Accident); Cerebral Strokes; Cerebrovascular Accidents; Cerebrovascular Accidents, Acute; Cerebrovascular Strokes; Stroke, Cerebrovascular; Strokes, Acute; Strokes, Cerebral; Strokes, Cerebrovascular; Vascular Accidents, Brain; Cerebral Stroke; Cerebrovascular Accident; Cerebrovascular Apoplexy; Vascular Accident, Brain

Networked: 53799 relevant articles (4187 outcomes, 11051 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Myocardial Infarction
2.	Atrial Fibrillation
3.	Stroke (Strokes)
4.	Hemorrhage
5.	Hypertension (High Blood Pressure)

Experts

1.	Lip, Gregory Y H: 229 articles (02/2016 - 01/2002)
2.	Chopp, Michael: 156 articles (01/2016 - 01/2002)
3.	Saver, Jeffrey L: 138 articles (01/2016 - 01/2002)
4.	Hankey, Graeme J: 136 articles (12/2015 - 03/2002)
5.	Montaner, Joan: 120 articles (12/2015 - 06/2002)
6.	Hacke, Werner: 113 articles (02/2016 - 01/2002)
7.	Yusuf, Salim: 113 articles (12/2015 - 03/2002)
8.	Qureshi, Adnan I: 108 articles (11/2015 - 03/2002)
9.	Hill, Michael D: 104 articles (12/2015 - 01/2002)
10.	Ovbiagele, Bruce: 99 articles (10/2015 - 01/2003)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Stroke:

1.	Aspirin (Acetylsalicylic Acid)FDA LinkGeneric 04/01/1999 - "Future studies should include an examination of those agents that have previously demonstrated efficacy in secondary stroke prevention, most notably, aspirin. " 01/01/2012 - "Currently, the best treatment for ICAD remains aspirin therapy, but many patients who are placed on aspirin continue to experience recurrent strokes. " 10/01/2000 - "Using the best estimate of the efficacy of aspirin to prevent first-time stroke and MI, PTOT and DA treatment recommendations whether or not to take aspirin were discordant for 38% of participants (16 of 42) (p < 0.001). " 10/01/2000 - "Finally, based on these treatment thresholds, using the best estimates of the efficacy of aspirin to prevent first-time stroke and MI, PTOT and DA treatment recommendations for individual participants were compared. " 06/01/2000 - "There was a highly significant reduction of 7 per 1000 (SD 1) in recurrent ischemic stroke (320 [1.6%] aspirin versus 457 [2. 3%] control, 2P<0.000001) and a less clearly significant reduction of 4 (SD 2) per 1000 in death without further stroke (5.0% versus 5. 4%, 2P=0.05). "
2.	Tissue Plasminogen Activator (Alteplase)FDA Link 09/01/2009 - "The submitted clinical evidence included several randomised controlled trials indicating that, in highly selected patients, alteplase administered at a licensed dose within 3 hours of the onset of acute ischaemic stroke is associated with a statistically significant reduction in the risk of death or dependency at 3 months compared with placebo, despite a significantly increased risk of symptomatic intracranial haemorrhage within the first 7-10 days. " 01/01/2005 - "Evidence from randomized clinical trials indicates that systemic administration of recombinant tissue plasminogen activator (rtPA) is a highly effective treatment for acute ischemic stroke, provided that treatment is administered within the first 3 h after stroke onset. " 01/01/2014 - "The efficacy of alteplase in acute ischaemic stroke (AIS) is highly time dependent. " 02/01/2009 - "Intravenous recombinant tissue plasminogen activator is a highly effective treatment for acute ischemic stroke, but routine provision is challenging. " 11/01/2002 - "However, the Cochrane systematic review of thrombolysis for acute ischaemic stroke suggests that alteplase is the most promising treatment for acute ischaemic stroke. "
3.	Warfarin (Coumadin)FDA LinkGeneric 12/01/2013 - "Warfarin anticoagulation is highly effective for stroke prevention in AF patients, but is underutilized especially in the elderly. " 01/01/2013 - "Warfarin therapy administered concomitantly with an antiplatelet agent dramatically reduced the incidence of ischemic stroke associated with postoperative PAF." 10/01/2012 - "In the general population, warfarin is highly effective for prophylaxis of ischaemic stroke, and though warfarin use likely increases the risk of intracranial haemorrhage, the absolute increase in risk is small. " 08/01/2011 - "Warfarin is the most widely used antithrombotic therapy for stroke prophylaxis for last several years, and now dabigatran (150 mg b.i.d.) is more effective than warfarin in stroke prevention in individuals at increased of stroke. " 03/01/2010 - "Warfarin is an anticoagulant effective in preventing stroke, but it has a narrow therapeutic range requiring optimal adherence to achieve the most favorable effects. "
4.	clopidogrel (Plavix)FDA Link 09/14/2005 - "Overall, pretreatment with clopidogrel resulted in a highly significant reduction in cardiovascular death, MI, or stroke from randomization through 30 days (70 [7.5%] vs 112 [12.0%]; adjusted OR, 0.59 [95% CI, 0.43-0.81]; P = .001; number needed to treat = 23). " 01/01/2003 - "The MATCH trial is currently being conducted to test the hypothesis that long-term administration of clopidogrel on top of ASA is superior to clopidogrel alone for the reduction of major ischaemic events in patients with recent TIA or ischaemic stroke who are at high risk of atherothrombotic recurrence. " 02/01/2011 - "Clopidogrel use was associated with a non-significant reduction of perioperative stroke/death (4.3% vs. 2.4%; p = 0.13) and disabling stroke (1.2% vs. 1.0%; p = 1) rates. " 07/01/2006 - "Clopidogrel has not shown significant reduction in reoccurrence of stroke and has not been studied for patients with a previous TIA. " 11/01/2006 - "A prediction model which allows to identify patients in whom clopidogrel or dipyridamol plus ASA is superior to ASA for the secondary prevention of stroke is presented."
5.	AnticoagulantsIBA 01/01/2014 - "Oral anticoagulants (OAC) are highly effective in preventing stroke, and there are evidence-based guidelines for the optimal use of OAC in patients with AF. " 09/01/2008 - "Antiplatelet therapy is highly effective in reducing the risk of recurrent vascular events and is recommended over oral anticoagulants for non-cardioembolic stroke. " 02/01/2000 - "Further studies examining the efficacy of anticoagulants in different stroke subgroups will be necessary in order to clarify optimal clinical practice." 10/15/2011 - "Our findings suggest important opportunities for practice-level improvement in stroke prevention for outpatients with AF and define a benchmark treatment rate before the introduction of newer anticoagulant agents." 12/01/2009 - "Anticoagulants are very effective for stroke prevention in patients with AF, overall a 64% relative risk reduction. "
6.	Perindopril FDA LinkGeneric 09/01/2011 - "The Perindopril Protection Against Recurrent Stroke Study (PROGRESS) was a randomized placebo-controlled trial which clearly demonstrated that perindopril-based blood pressure (BP)-lowering treatment is one of the most effective and generalizable strategies for secondary prevention of stroke. " 06/01/2006 - "The Perindopril Protection Against Recurrent Stroke Study (PROGRESS) was a randomized, placebo-controlled trial that established the beneficial effects of BP lowering in 6105 patients with cerebrovascular disease. " 10/01/2005 - "This study was a subsidiary analysis of the Perindopril Protection Against Recurrent Stroke Study (PROGRESS)--a randomized, placebo-controlled trial that established the beneficial effects of blood pressure--lowering in a heterogeneous group of patients with cerebrovascular disease. " 01/01/2001 - "Perindopril 4 to 8 mg once daily significantly decreased carotid-femoral aortic pulse wave velocity (PWV), improved arterial compliance, reduced left ventricular mass index and, in patients with recent cerebral ischaemia and/or stroke, preserved cerebral blood flow despite significantly reducing SBP and DBP. " 12/01/1996 - "Chronic treatment with perindopril is beneficial for the prevention of stroke in SPSHR, through the preservation of the myogenic response properties of the cerebral arteries, and the attenuation of tissue damage in the brain and kidneys."
7.	Platelet Aggregation Inhibitors (Antiplatelet Drugs)IBA 01/01/2013 - "Anticoagulant and/or antiplatelet agents are usually recommended for stroke prevention;however, such treatments remain highly controversial, and there are inadequate data to compare the efficacy of anticoagulation and antiplatelet therapy. " 10/01/2012 - "Those who improved had significantly lower systolic blood pressure before thrombolysis and were less often administered antiplatelet agents before index stroke. " 09/01/2009 - "In the cases of distal embolic stroke, all three patients achieved good results following the use of antiplatelet agents. " 10/01/2003 - "Although antiplatelet agents have not proved to be beneficial in the primary prevention of stroke, they are recommended in patients with ICS in order to lower the risk of heart attack associated with this pathology. " 01/01/2010 - "Prior major clinical trials of various secondary stroke prevention regimens pointed to a greater efficacy of dual antiplatelet agents if initiated early from symptom onset. "
8.	glucuronyl glucosamine glycan sulfate (Vessel)IBA 04/01/2013 - "The ReFlow (Mechanical Recanalization With Flow Restoration in Acute Ischemic Stroke) study shows that mechanical recanalization with flow restoration is highly effective in stroke patients with a large intracranial vessel occlusion presenting within 4.5 h after symptom onset. " 08/01/1996 - "Small-vessel strokes had the best outcome. " 03/12/2015 - "Among patients with acute ischemic stroke with a proximal vessel occlusion, a small infarct core, and moderate-to-good collateral circulation, rapid endovascular treatment improved functional outcomes and reduced mortality. " 08/01/2014 - "In a derivation cohort of anterior circulation large vessel occlusion stroke patients treated with endovascular therapy within 8 hours from time last seen well (n=247), we performed logistic regression to identify independent predictors of good outcome (90-day modified Rankin Scale, 0-2). " 06/17/2014 - "Our findings suggest that the Penumbra system might be effective for treatment in elderly patients or patients with high NIHSS score wherein rt-PA therapy is inadvisable or ineffective in ischemic stroke secondary to large vessel occlusion. "
9.	Dipyridamole (Persantine)FDA LinkGeneric 09/15/1998 - "The sustained release dipyridamole produced a significant risk reduction of 16% for stroke, 15% for stroke and/or death but no significant reduction of mortality. " 07/01/2008 - "Recent studies suggest that dipyridamole (DP) may exert stroke protective effects beyond platelet inhibition. " 11/01/2013 - "A recent review discussed results from clinical trials that have compared the efficacy of ASA monotherapy versus ASA + extended release dipyridamole in secondary stroke prevention. " 07/01/2008 - "The purpose of this review was to discuss results from clinical trials that have compared the efficacy of ASA monotherapy versus ASA + extendedrelease dipyridamole in secondary stroke prevention. " 07/01/2008 - "Based on the results from these 2 large, randomized trials, ASA + dipyridamole was more effective than ASA monotherapy as first-line therapy for secondary stroke prevention in these patients with a history of minor stroke or TIA of noncardioembolic etiology."
10.	Vitamin K FDA Link 11/01/2013 - "Vitamin K antagonists (VKAs) are highly effective in preventing recurrent ischaemic stroke but have important limitations and are thus underused. " 11/01/2012 - "Vitamin K antagonists are highly effective for stroke prevention. " 09/01/2013 - "Vitamin K antagonists (VKA) had several decades of proven efficacy in AF-related stroke prevention but the drug's numerous limitations make its implementation difficult for practitioners and patients. " 03/01/2012 - "Vitamin K antagonists are effective in reducing the risk of stroke but optimal use of these drugs remains difficult. " 07/01/2009 - "Vitamin K antagonists are very effective for the prevention of cardioembolic stroke but have numerous limitations that limit their uptake in eligible patients with AF and reduce their effectiveness in treated patients. "

Therapies and Procedures

1.	Carotid Endarterectomy 07/01/1993 - "In those areas where studies are complete, carotid endarterectomy has been shown to be highly effective in reducing stroke risk. " 06/01/2003 - "The efficacy of carotid endarterectomy (CEA) for prevention of stroke has been demonstrated in randomized trials; however, the optimal approach in patients excluded from these trials or who have other significant comorbid conditions remains controversial, particularly with the advent of percutaneous interventions. " 11/01/2007 - "Although carotid endarterectomy (CEA), the gold standard in stroke prevention, has been performed in the late stage after the insult, its optimal timing remains unclear. " 08/01/1988 - "Additionally, carotid endarterectomy does not render complete protection against stroke and the follow-up curves for the respective treatments do not differ meaningfully, even during longterm observation. " 01/01/2012 - "Continuous improvement in carotid artery stenting (CAS) outcomes, especially for periprocedural death and stroke in high-surgical-risk patients, have been seen in recent randomized trials of CAS versus carotid endarterectomy and CAS registries. "
2.	Thrombolytic Therapy 10/01/2014 - "Ample evidence has shown that patients presenting early and receiving intravenous thrombolytic therapy have the best chance for significant improvement in functional outcome, particularly if they are transported to specialized stroke centers. " 12/01/2010 - "Only the latter has been proven to be effective in larger randomized trials and is a Class 1/Level A recommendation in national or international guidelines.(1) This review summarizes the evidence for thrombolytic therapy of acute ischemic stroke with emphasis on progress regarding the approved intravenous treatment. " 07/01/2015 - "Thrombolytic therapy has been proven to be effective in acute ischemic stroke treatment and shown to improve long-term functional outcomes. " 09/01/2009 - "Thrombolytic therapy has been proven to be beneficial in selected patients with ischaemic strokes. " 01/01/1993 - "Emergency cerebral angiography, which can be carried out relatively safely, adds important information about the nature and extent of the arterial occlusions, and the recanalization efficacy of fibrinolytic therapy for patients with acute stroke. "
3.	Stents 10/01/2007 - "Restenosis as well as the rate of new neurologic events during follow-up suggests some efficacy of stroke prevention by using the latest-generation, highly trackable, balloon-expandable stents." 08/01/2015 - "Overall, although evidence regarding the efficacy of endovascular treatment in acute stroke has been equivocal, recent publications of large multicentre randomised controlled trials indicate benefit of intra-arterial stent retriever reperfusion in patients selected by appropriate imaging and treated early by experienced operators, and it will likely remain an important adjunct to established medical treatment with intravenous tPA. " 01/01/2015 - "Recent randomised clinical trials have convincingly shown that endovascular therapy with the use of a retrievable stent considerably improves the chance of a good outcome in selected patients with acute ischaemic stroke and an occlusion of a proximal intracranial artery in the anterior circulation. " 07/01/2015 - "Stent retrievers appear to be safe and effective devices, achieving high recanalisation rates and good clinical outcomes in the endovascular treatment of patients with acute ischaemic stroke due to the occlusion of intracranial arteries in comparison with the clot retriever Merci®." 01/01/2015 - "Acute ischemic stroke in a child due to basilar artery occlusion treated successfully with a stent retriever."
4.	Thrombectomy 04/14/2015 - "Mechanical thrombectomy in select patients with acute ischemic stroke and proximal artery occlusions has demonstrated substantial rates of partial or complete arterial recanalization and improved outcomes compared with IV rtPA or best medical treatment alone in multiple randomized clinical trials. " 12/01/2015 - "The mechanical thrombectomy (MT) for endovascular clot retrieval has dramatically improved successful revascularization and clinical outcome in selected acute stroke patients. " 01/01/2014 - "Many physicians debate the efficacy of mechanical thrombectomy for ischaemic stroke, but most agree that to establish potential benefit, patient selection must be examined further. " 08/01/2015 - "First-generation mechanical thrombectomy devices such as the MERCI Retriever (Stryker, Kalamazoo, MI, USA) and Penumbra aspiration device (Penumbra Inc., Alameda, CA, USA) demonstrated safety and higher rates of recanalisation in the MERCI and Penumbra Pivotal Stroke Trial; however, there was no significant improvement in clinical outcome. " 09/01/2015 - "Improvements in patient selection using clinical and imaging criterion along with technical and technological advancements in mechanical thrombectomy have made possible a significantly improved outcome in stroke patients. "
5.	Activities of Daily Living (ADL) 01/01/2014 - "Balance self-efficacy, a psychological factor, should not be overlooked in attempting to improve functional outcomes in stroke survivors because balance self-efficacy impact ADL through the mediation of balance ability It would be appropriate to assess the balance efficacy as well as balance ability for maximizing performing tasks such as ADLs for individual with stroke Interventions that use a combination of balance training and balance self-efficacy enhancement could be the most effective for improving ADL in the case of community-dwelling stroke patients." 08/01/2011 - "Responsiveness, minimal detectable change, and minimal clinically important difference of the Nottingham Extended Activities of Daily Living Scale in patients with improved performance after stroke rehabilitation." 10/01/2015 - "[Conclusion] The present study showed that robot-assisted gait training is not only effective in improving balance and gait performance but also improves trunk balance and motor skills required by high-severity stroke patients to perform activities daily living. " 01/01/2015 - "Patients participating in the ESD rehabilitation models were, compared with traditional treatment, significantly associated with improved ADL ability measured by the mRS when controlling for confounding factors, indicating that patients with social needs and physical impairment after stroke may benefit from ESD rehabilitation models." 12/01/2014 - "Both individuals after stroke rehabilitated in hospital and those rehabilitated in environmental conditions achieved a significant improvement in functional of paretic limbs and improving independence in activities of daily living. "