Section 4: Other treatment ideas and supportive stroke care
- Hemodilution and vasodilators don’t seem to work. A very selected subset of patients may benefit from pressors. Hypothermia had mixed results.
- Albumin may have a positive impact, definitive results pending.
- Nimodipine works in SAH but not in ischemic stroke; the neuroprotective effect likely outweighed by BP lowering.
- The combination of caffeine and alcohol seemed relatively safe in a pilot study!
- For patients already on statins, interrupting therapy even briefly was associated with worse outcomes.
- Specialized stroke outcomes are key: the benefits persist for years, with an effect comparable to administration of tPA. The number needed to treat for a CSC to prevent 1 death or institutional care at 1 year was only 29.
- Healthcare providers can safely do a bedside swallow eval; a “wet voice” after swallowing is a good predictor of aspiration.
- PREVAIL study showed lovenox is better than BID heparin for DVT prevention in ischemic stroke.
- 25% of strokes will deteriorate within 1-2 days: 1/3 because of stroke progression, 1/3 because of swelling, and the remaining third equally split between hemorrhage and recurrent stroke.
- The benefit for decompressive surgery is only shown for patients younger than 60.
And that’s all, folks. Normal length articles return next week.