Stroke

Donnan, Geoffrey A.; Fisher, Marc; Macleod, Malcolm; Davis, Stephen M.

doi:10.1016/s0140-6736(08)60694-7

Cited by 2,231 publications

(1,567 citation statements)

References 145 publications

Supporting

Mentioning

1,514

Contrasting

Unclassified

Order By: Relevance

“…Advances have occurred in the prevention and treatment of stroke during the past decade [39].However, the lack of high quality evidence on the effects of blood glucose manipulation in acute stroke is reflected by the wide variation in current clinical practice.…”

Section: Practical Implications Regarding Glucose Management During Smentioning

confidence: 99%

Management of blood glucose in patients with stroke

Radermecker

Scheen

2010

Diabetes & Metabolism

View full text Add to dashboard Cite

SUMMARYStroke is a leading cause of death worldwide and the commonest cause of long-term disability amongst adults, more particularly in patients with diabetes mellitus and arterial hypertension.Increasing evidence suggests that disordered physiological variables following acute ischaemic stroke, especially hyperglycaemia, adversely affect outcomes. Post-stroke hyperglycaemia is common (up to 50 % of patients) and may be rather prolonged, regardless of diabetes status. A substantial body of evidence has demonstrated that hyperglycaemia has a deleterious effect upon clinical and morphological stroke outcomes. Therefore, hyperglycaemia represents an attractive physiological target for acute stroke therapies.However, whether intensive glycaemic manipulation positively influences the fate of ischaemic tissue remains unknown. One major adverse event of management of hyperglycaemia with insulin (either glucose-potassium-insulin infusions or intensive insulin therapy) is the occurrence of hypoglycaemia, which can also induce cerebral damages. Novel insights into post-stroke hyperglycaemia management are derived from continuous glucose monitoring systems (CGMS). This article aims to describe the adverse effects of hyperglycaemia following acute ischaemic stroke and the risk associated to iatrogenic hypoglycaemia, to summarise the evidence from current glucose-lowering treatment trials and to show the usefulness of CGMS in both nondiabetic and diabetic patients with acute stroke. Key-words Mots-clé :Accident vasculaire cérébral -Diabète -Hyperglycémie -Hypoglycémie - Insulinothérapie -CGMS

show abstract

Section: Practical Implications Regarding Glucose Management During Smentioning

confidence: 99%

Management of blood glucose in patients with stroke

Radermecker

Scheen

2010

Diabetes & Metabolism

View full text Add to dashboard Cite

show abstract

“…A balanced level of MMP activity is important for vascular remodeling after ischemic stroke [44]. Therefore an extended inhibition of MMPs through the use of broad spectrum inhibitors might prove deleterious [45,46].…”

Section: Role Of Mmps In Bbb Disruptionmentioning

confidence: 99%

Blood-Brain Barrier Disruption During Acute Ischemic Stroke - The Role of Matrix Metalloproteinases and Tight Junctions Proteins

Dulamea¹

2014

JTMR

View full text Add to dashboard Cite

Ischemic stroke is a major cause of death and disability worldwide. Intravenous administration of recombinant tissue plasminogen activator (rtPA) is the only approved pharmacological therapy for patients with acute ischemic stroke. Treatment with intravenous rtPA is associated with increased rates of intracranial hemorrhage. This review discusses recent findings about the changes of the components of neurovascular unit and the alteration of blood-brain barrier during stroke. The analysis provide information in order to identify factors with predictive value for hemorrhagic transformation of ischemic stroke both within or after the thrombolysis time window.

show abstract

“…Les échecs répétés de ces essais ont conduit à remettre en question la pertinence de la stratégie, des modèles précliniques ou de l'évaluation clinique (pour une discussion de ces points voir [16]). Si les recommandations STAIR (Stroke therapy academic industry roundtable) 1 [17] pour l'évaluation préclinique ont permis d'améliorer certaines étapes du développement de molécules thérapeutiques, un effort doit être encore fait sur les étapes translationnelles [18], avec notamment la prise en compte de l'évolution cinétique et spatiale de la cible testée, afin de mieux sélec-tionner les patients (Tableau I). Le développement du NXY059, un agent anti-oxydant dont le développement pré-clinique s'est fait selon les critères de recommandation STAIR, est un bon exemple des efforts qui sont encore nécessaires pour réussir à obtenir des produits efficaces chez l'homme.…”

Section: De Nouvelles Cibles Pour Une Neuroprotection à La Phase Aiguë ?unclassified

“…Des progrès indéniables ont été faits dont témoigne une diminution progressive, au cours des deux dernières décennies, de l'incidence des AVC. C'est le résultat de la validation de traitements préventifs dont l'efficacité a été établie par de larges études de morbimortalité au niveau de preuve important [1]. Au-delà d'un effet sur l'incidence, certains traitements préventifs exercent un effet de neuroprotection dont témoigne une moindre sévérité de l'accident vasculaire lorsqu'il survient chez les patients traités.…”

unclassified