The perception that the more aggressive glucose control is the better the patient will be doesn’t hold true in the multicentre SHINE* trial. Intensive glucose control at a target of 80–130 mg/dL with intravenous (IV) insulin did not improve outcomes in patients with ischaemic stroke. Instead, it carried an increased risk of severe hypoglycaemia.
Among patients with a recent acute ischaemic stroke treated with thrombolytic therapy, intensive blood pressure (BP)-lowering conferred no additional benefit in functional recovery compared with guideline-recommended BP-lowering, despite a reduced risk of intracranial haemorrhage with intensive therapy, according to results of the ENCHANTED* trial.
Hospitalization rates for stroke increased by 20 percent each year between 2008 and 2015, according to a large US study, and these incidents were apparently tied to spikes in opioid misuse and cases of drug-related infective endocarditis.
The evacuation of moderate-to-large brain bleeds using stereotactic catheter aspiration and the thrombolytic agent alteplase (ie, MISTIE* approach) was no better than standard medical therapy in providing functional improvement post-stroke, according to the results of the MISTIE III trial presented at ISC 2019. However, this strategy appears to hold promise in reducing mortality risk.
Patients presenting within 9 hours from stroke onset or with wake-up stroke can still benefit from thrombolytic therapy based on automated computed tomography (CT) perfusion imaging-guided patient selection, according to the EXTEND* study presented at ISC 2019.
Nicotine may not have a neuroprotective effect on intracerebral haemorrhage (ICH) as previously suggested in animal studies, with former or current smokers demonstrating no difference in post-ICH functional outcomes compared with non-smokers, according to findings from the US-based ERICH* study.
Prehospital, transdermal delivery of the nitric oxide (NO) donor nitroglycerin did not reduce blood pressure (BP) and post-stroke disability in patients with suspected ultra-acute stroke, according to the results of the RIGHT*-2 trial presented at ISC 2019, thus debunking the conventional belief that early NO administration to supplement the low vascular NO concentrations may benefit acute stroke.
Treatment with the second-generation hydrogel coils significantly reduces the rate of aneurysm recurrence compared with standard platinum coils, with no increase in adverse events, reveals the HEAT* study presented at ISC 2019.
Not only does the CGRP* inhibitor galcanezumab show sustained efficacy in migraine patients, long-term treatment does not come with excess cardiovascular (CV) risk, according to studies presented at the AAN 2021 Annual Meeting.
Migraine and headache are common ailments of people living in the modern era. Dr Jon Marshall of The Singapore Headache and Migraine Clinic shares his insights with Pearl Toh on how to manage migraine and headache using non-pharmaceutical strategies, with a focus on the manual medicine approach.
Among atrial fibrillation (AF) patients with clinically defined heart failure, catheter ablation yields greater survival gains, freedom from AF recurrence, and quality of life boost than does drug therapy, according to the results of the CABANA AF* substudy.
Combination treatment with three or more antihypertensive drugs provides greater blood pressure (BP)-lowering effect than monotherapy, results of a study have shown. However, the net benefit may be lessened when side effects are considered.