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01-04-2014 | Review Article

Current Management of Delayed Cerebral Ischemia: Update from Results of Recent Clinical Trials

Authors: Shakira Brathwaite, R. Loch Macdonald

Published in: Translational Stroke Research | Issue 2/2014

Abstract

Subarachnoid hemorrhage (SAH) accounts for 5–7 % of all strokes worldwide and is associated with high mortality and morbidity. Even after surgical intervention, approximately 30 % of patients develop long-term cognitive and neurological deficits that significantly affect their capacity to return to work or daily life unassisted. Much of this stems from a secondary ischemic phenomenon referred to as delayed cerebral ischemia (DCI). While DCI has been historically attributed to the narrowing of the large basal cerebral arteries, it is now recognized that numerous pathways contribute to its pathogenesis, including microcirculatory dysfunction, microthrombosis, cortical spreading depression, and early brain injury. This paper seeks to summarize some of the key pathophysiological events that are associated with poor outcome after SAH, provide a general overview of current methods of treating SAH patients, and review the results of recent clinical trials directed at improving outcome after SAH. The scientific basis of these studies will be discussed, in addition to the available results and recommendations for effective patient management. Therapeutic methods under current clinical investigation will also be addressed. In particular, the mechanisms by which they are expected to elicit improved outcome will be investigated, as well as the specific study designs and anticipated time lines for completion.

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Title: Current Management of Delayed Cerebral Ischemia: Update from Results of Recent Clinical Trials
Authors: Shakira Brathwaite
R. Loch Macdonald
Publication date: 01-04-2014
Publisher: Springer US
Published in: Translational Stroke Research / Issue 2/2014
Print ISSN: 1868-4483
Electronic ISSN: 1868-601X
DOI: https://doi.org/10.1007/s12975-013-0316-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Current Management of Delayed Cerebral Ischemia: Update from Results of Recent Clinical Trials

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

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