Higher body temperature has been associated with poor functional outcomes in patients with CVA. This multicenter trial randomized CVA patients (temp 36-39 C) to paracetamol (1gram q4 for 3 days) or placebo within 12 hours. Although there was no overall difference in the primary outcome (improvement beyond expectation), subgroup analysis did show improvement in those with temp 37-39 C, and no difference in serious adverse events between the 2 groups. An editorialist agrees that this seemingly innocuous intervention is likely highly valuable in CVA patients with elevated body temperatures (abstract)
In this large multicenter trial, patients with minor stroke or TIA were randomized to clopidogrel+ASA or ASA alone; 90-day stroke occurred in 8% vs 12% respectively, and rates of hemorrhage or hemorrhagic stroke were the same (abstract).
These guidelines provide an evidence based for the use of periprocedural antithrombotics in patients with cerebrovascular disease. They recommend continuing ASA-warfarin for dental procedures, and most other minor procedures. There is little evidence to support the use of procedural bridging with heparin, and it does increase the risk of bleeding. Cessation of therapy for 7 […]
A large analysis from a stroke registry found better outcomes with earlier thrombolytics for acute ischemic stroke; every 15 minutes earlier was associated with an odds ratio of 0.96 for in-hospital death or intracranial hemorrhage, and an odds ratio of 1.03 for being discharged home and 1.04 for walking independently at discharge (abstract).