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.