Latest & greatest articles for stroke

The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on stroke or other clinical topics then use Trip today.

This page lists the very latest high quality evidence on stroke and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.

What is Trip?

Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care.

Trip has been online since 1997 and in that time has developed into the internet’s premier source of evidence-based content. Our motto is ‘Find evidence fast’ and this is something we aim to deliver for every single search.

As well as research evidence we also allow clinicians to search across other content types including images, videos, patient information leaflets, educational courses and news.

For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via jon.brassey@tripdatabase.com

Top results for stroke

61. Caregivers' effects of augmented cognitive-behavioural therapy for post-stroke depressive symptoms in patients: secondary analyses to a randomized controlled trial

Caregivers' effects of augmented cognitive-behavioural therapy for post-stroke depressive symptoms in patients: secondary analyses to a randomized controlled trial To investigate the concomitant effects of two patient-directed interventions for post-stroke depressive symptoms on caregivers' well-being.Secondary analyses of the results of a randomized controlled trial.Fifty caregivers of stroke patients receiving outpatient rehabilitation.Stroke patients and their caregivers were randomly

2019 EvidenceUpdates

62. Prehospital stroke scales as screening tools for early identification of stroke and transient ischemic attack. (PubMed)

Prehospital stroke scales as screening tools for early identification of stroke and transient ischemic attack. Rapid and accurate detection of stroke by paramedics or other emergency clinicians at the time of first contact is crucial for timely initiation of appropriate treatment. Several stroke recognition scales have been developed to support the initial triage. However, their accuracy remains uncertain and there is no agreement which of the scales perform better.To systematically identify (...) and review the evidence pertaining to the test accuracy of validated stroke recognition scales, as used in a prehospital or emergency room (ER) setting to screen people suspected of having stroke.We searched CENTRAL, MEDLINE (Ovid), Embase (Ovid) and the Science Citation Index to 30 January 2018. We handsearched the reference lists of all included studies and other relevant publications and contacted experts in the field to identify additional studies or unpublished data.We included studies evaluating

2019 Cochrane

63. Diagnostic evaluation of cryptogenic stroke

Diagnostic evaluation of cryptogenic stroke Diagnostic Evaluation of Cryptogenic Stroke – Clinical Correlations Search Diagnostic Evaluation of Cryptogenic Stroke April 2, 2019 8 min read Dixon Yang, MD Peer Reviewed Case and Introduction A 52-year-old right-handed woman with hypertension is brought in by ambulance after her daughter notices a sudden onset of nonsensical speech and trouble walking. On exam, she has an expressive aphasia with right-sided hemiparesis. Her vitals are stable (...) with her blood pressure well-controlled by a home medication. Computed tomography (CT) with angiography reveals signs of early acute ischemic changes in the right middle cerebral artery territory but no large vessel occlusion. She has no metabolic disturbances, an unremarkable complete blood count, and normal coagulation profile. She receives intravenous tissue plasminogen activator with improvement in symptoms and is admitted to the stroke unit. Further work up with 24-hour Holter monitor records

2019 Clinical Correlations

64. The effect and optimal parameters of repetitive transcranial magnetic stimulation on motor recovery in stroke patients: a systematic review and meta-analysis of randomized controlled trials

The effect and optimal parameters of repetitive transcranial magnetic stimulation on motor recovery in stroke patients: a systematic review and meta-analysis of randomized controlled trials The primary aim of this meta-analysis was to evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on limb movement recovery post-stroke and cortex excitability, to explore the optimal parameters of rTMS and suitable stroke population. Second, adverse events were also included.The (...) databases of PubMed, EBSCO, MEDLINE, the Cochrane Central Register of Controlled Trials, EBM Reviews-Cochrane Database, the Chinese National Knowledge Infrastructure, and the Chinese Science and Technology Journals Database were searched for randomized controlled trials exploring the effects of rTMS on limb motor function recovery post-stroke before December 2018.The effect sizes of rTMS on limb motor recovery, the effect size of rTMS stimulation parameters, and different stroke population were

2019 EvidenceUpdates

65. Safety and efficacy of sonothrombolysis for acute ischaemic stroke: a multicentre, double-blind, phase 3, randomised controlled trial

Safety and efficacy of sonothrombolysis for acute ischaemic stroke: a multicentre, double-blind, phase 3, randomised controlled trial Pulsed-wave ultrasound increases the exposure of an intracranial thrombus to alteplase (recombinant tissue plasminogen activator), potentially facilitating early reperfusion. We aimed to ascertain if a novel operator-independent transcranial ultrasound device delivering low-power high-frequency ultrasound could improve functional outcome in patients treated (...) with alteplase after acute ischaemic stroke.We did a multicentre, double-blind, phase 3, randomised controlled trial (CLOTBUST-ER) at 76 medical centres in 14 countries. We included patients with acute ischaemic stroke (National Institutes of Health Stroke Scale score ≥10) who received intravenous thrombolysis (alteplase bolus) within 3 h of symptom onset in North America and within 4·5 h of symptom onset in all other countries. Participants were randomly allocated (1:1) via an interactive web response

2019 EvidenceUpdates

66. Glucose Modifies the Effect of Endovascular Thrombectomy in Patients With Acute Stroke

Glucose Modifies the Effect of Endovascular Thrombectomy in Patients With Acute Stroke Background and Purpose- Hyperglycemia is a negative prognostic factor after acute ischemic stroke but is not known whether glucose is associated with the effects of endovascular thrombectomy (EVT) in patients with large-vessel stroke. In a pooled-data meta-analysis, we analyzed whether serum glucose is a treatment modifier of the efficacy of EVT in acute stroke. Methods- Seven randomized trials compared EVT (...) with standard care between 2010 and 2017 (HERMES Collaboration [highly effective reperfusion using multiple endovascular devices]). One thousand seven hundred and sixty-four patients with large-vessel stroke were allocated to EVT (n=871) or standard care (n=893). Measurements included blood glucose on admission and functional outcome (modified Rankin Scale range, 0-6; lower scores indicating less disability) at 3 months. The primary analysis evaluated whether glucose modified the effect of EVT over standard

2019 EvidenceUpdates

67. Effect of Workflow Improvements in Endovascular Stroke Treatment

Effect of Workflow Improvements in Endovascular Stroke Treatment Background and Purpose- Rapid initiation of endovascular stroke treatment is associated with better clinical outcome. The effect of specific improvements is not well known. We performed a systematic review and meta-analysis on the effectiveness of specific workflow improvements on time to treatment and outcome. Methods- A random-effects meta-analysis was used to evaluate the difference in mean time to treatment between (...) <0.001) for teamwork, and 64 minutes (95% CI, 24-104; P=0.002) for feedback. The mean difference in time to treatment of studies with multiple interventions implemented simultaneously was 50 minutes (95% CI, 31-69; P<0.001) in favor of the intervention group. Patients in the intervention group had increased likelihood of favorable outcome (risk ratio [RR], 1.39; 95% CI, 1.15-1.66; P<0.001). Conclusions- Interventions in the workflow of endovascular stroke treatment lead to a significant reduction

2019 EvidenceUpdates

68. A novel biomarker-based prognostic score in acute ischemic stroke: The CoRisk score

A novel biomarker-based prognostic score in acute ischemic stroke: The CoRisk score To derive and externally validate a copeptin-based parsimonious score to predict unfavorable outcome 3 months after an acute ischemic stroke (AIS).The derivation cohort consisted of patients with AIS enrolled prospectively at the University Hospital Basel, Switzerland. The validation cohort was prospectively enrolled after the derivation cohort at the University Hospital of Bern and University Hospital Basel (...) , Switzerland, as well as Frankfurt a.M., Germany. The score components were copeptin levels, age, NIH Stroke Scale, and recanalization therapy (CoRisk score). Copeptin levels were measured in plasma drawn within 24 hours of AIS and before any recanalization therapy. The primary outcome of disability and death at 3 months was defined as modified Rankin Scale score of 3 to 6.Overall, 1,102 patients were included in the analysis; the derivation cohort contributed 319 patients, and the validation cohort

2019 EvidenceUpdates

69. Post-Thrombolysis Recanalization in Stroke Referrals for Thrombectomy: Incidence, Predictors, and Prediction Scores

Post-Thrombolysis Recanalization in Stroke Referrals for Thrombectomy: Incidence, Predictors, and Prediction Scores Background and Purpose—Whether all acute stroke patients with large vessel occlusion need to undergo intravenous thrombolysis before mechanical thrombectomy (MT) is debated as (1) the incidence of post-thrombolysis early recanalization (ER) is still unclear; (2) thrombolysis may be harmful in patients unlikely to recanalize; and, conversely, (3) transfer for MT may be unnecessary

2019 EvidenceUpdates

70. Improvement of Upper Limb Motor Control and Function After Competitive and Noncompetitive Volleyball Exercises in Chronic Stroke Survivors: A Randomized Clinical Trial

Improvement of Upper Limb Motor Control and Function After Competitive and Noncompetitive Volleyball Exercises in Chronic Stroke Survivors: A Randomized Clinical Trial To investigate the effects of competitive and noncompetitive volleyball exercises on the functional performance and motor control of the upper limbs in chronic stroke survivors.Randomized clinical trial.Outpatient rehabilitation center.Chronic stroke survivors (N=48).Participants were randomly assigned to competitive (n=16 (...) the efficacy of the preprogramming and execution of reach and grasp movements, as well as a shift from feedback to feedforward control of the affected upper limb in chronic stroke survivors. This may well be a potential underlying mechanism for improving functional performance.Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

2019 EvidenceUpdates

71. The effectiveness of somatosensory retraining for improving sensory function in the arm following stroke: a systematic review

The effectiveness of somatosensory retraining for improving sensory function in the arm following stroke: a systematic review The aim of this study was to evaluate if somatosensory retraining programmes assist people to improve somatosensory discrimination skills and arm functioning after stroke.Nine databases were systematically searched: Medline, Cumulative Index to Nursing and Allied Health Literature, PsychInfo, Embase, Amed, Web of Science, Physiotherapy Evidence Database, OT seeker (...) , and Cochrane Library.Studies were included for review if they involved (1) adult participants who had somatosensory impairment in the arm after stroke, (2) a programme targeted at retraining somatosensation, (3) a primary measure of somatosensory discrimination skills in the arm, and (4) an intervention study design (e.g. randomized or non-randomized control designs).A total of 6779 articles were screened. Five group trials and five single case experimental designs were included ( N = 199 stroke survivors

2019 EvidenceUpdates

72. Does fluoxetine improve recovery after stroke? (PubMed)

Does fluoxetine improve recovery after stroke? The studyFOCUS Trial Collaboration. Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial. Lancet 2019;393:256-74.The study was funded by the UK Stroke Association and the NIHR Health Technology Assessment Programme project number 13/04/30.To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000729/a-commonly-used-antidepressant-doesnt-improve

2019 BMJ

73. Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. (PubMed)

Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. Catheter ablation is effective in restoring sinus rhythm in atrial fibrillation (AF), but its effects on long-term mortality and stroke risk are uncertain.To determine whether catheter ablation is more effective than conventional medical therapy for improving outcomes in AF.The Catheter Ablation vs (...) Antiarrhythmic Drug Therapy for Atrial Fibrillation trial is an investigator-initiated, open-label, multicenter, randomized trial involving 126 centers in 10 countries. A total of 2204 symptomatic patients with AF aged 65 years and older or younger than 65 years with 1 or more risk factors for stroke were enrolled from November 2009 to April 2016, with follow-up through December 31, 2017.The catheter ablation group (n = 1108) underwent pulmonary vein isolation, with additional ablative procedures

2019 JAMA

74. Evaluation of reconfigurations of acute stroke services in different regions of England and lessons for implementation: a mixed-methods study

Evaluation of reconfigurations of acute stroke services in different regions of England and lessons for implementation: a mixed-methods study Evaluation of reconfigurations of acute stroke services in different regions of England and lessons for implementation: a mixed-methods study Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from (...) the navigation or try a website search above to find the information you need. >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> 1)"> {{metadata.Title}} {{metadata.Headline}} Centralising acute stroke services in urban areas can reduce mortality and length of stay, and increase delivery of evidence-based care; type of service model, planning change and context affect implementation. {{author}} {{($index , , , , , , , , , , & . Naomi J Fulop 1, * , Angus I G Ramsay 1 , Rachael M Hunter 2 , Christopher

2019 NIHR HTA programme

75. Stroke Outcomes in the COMPASS Trial

Stroke Outcomes in the COMPASS Trial Strokes were significantly reduced by the combination of rivaroxaban plus aspirin in comparison with aspirin in the COMPASS trial (Cardiovascular Outcomes for People Using Anticoagulation Strategies). We present detailed analyses of stroke by type, predictors, and antithrombotic effects in key subgroups.Participants had stable coronary artery or peripheral artery disease and were randomly assigned to receive aspirin 100 mg once daily (n=9126), rivaroxaban 5 (...) mg twice daily (n=9117), or rivaroxaban 2.5 mg twice daily plus aspirin (n=9152). Patients who required anticoagulation or had a stroke within 1 month, previous lacunar stroke, or intracerebral hemorrhage were excluded.During a mean follow-up of 23 months, fewer patients had strokes in the rivaroxaban plus aspirin group than in the aspirin group (83 [0.9% per year] versus 142 [1.6% per year]; hazard ratio [HR], 0.58; 95% CI, 0.44-0.76; P<0.0001). Ischemic/uncertain strokes were reduced by nearly

2019 EvidenceUpdates

76. Comparison of prasugrel and clopidogrel in patients with non-cardioembolic ischaemic stroke: a phase 3, randomised, non-inferiority trial (PRASTRO-I)

Comparison of prasugrel and clopidogrel in patients with non-cardioembolic ischaemic stroke: a phase 3, randomised, non-inferiority trial (PRASTRO-I) The effect of prasugrel in terms of the prevention of recurrence of ischaemic stroke is unknown. We investigated the non-inferiority of prasugrel to clopidogrel for prevention of ischaemic stroke, myocardial infarction, and death from other vascular causes in Japanese patients with non-cardioembolic stroke.In this phase 3 randomised, double-blind (...) , non-inferiority trial, patients aged 20-74 years who had had a non-cardioembolic stroke in the previous 1-26 weeks were recruited from 224 hospitals in Japan. Eligible patients were randomly assigned (1:1) to receive prasugrel (3·75 mg/day) or clopidogrel (75 mg/day) orally for 96-104 weeks. Randomisation was stratified according to stroke subtype. The randomisation schedule was generated by an independent statistician who created a computer-generated random number sequence. Patients

2019 EvidenceUpdates

77. No evidence of effectiveness of mirror therapy early after stroke: an assessor-blinded randomized controlled trial

No evidence of effectiveness of mirror therapy early after stroke: an assessor-blinded randomized controlled trial The aim of this study was to investigate the efficacy of mirror therapy on upper-limb recovery in early post-stroke patients.Assessor-blinded randomized controlled trial.Inpatient rehabilitation clinic.A total of 40 patients with upper-limb impairment due to a first-ever ischaemic or haemorrhagic stroke, within four weeks from the cerebrovascular accident.The intervention group (...) -Meyer (40.6 (21.3) vs. 38.3 (23.4)), ARAT (31.9 (23.0) vs. 30 (24.1)) and FIM (100.3 (21.9) vs. 99.4 (22.6)) scores. However, at T1, no significant difference was observed between the sham therapy and mirror therapy groups, neither for the Fugl-Meyer, nor for ARAT and FIM scores.Compared with sham therapy, mirror therapy did not add additional benefit to upper-limb recovery early after stroke.

2019 EvidenceUpdates

78. Performance of the RACE Score for the Prehospital Identification of Large Vessel Occlusion Stroke in a Suburban/Rural EMS Service

Performance of the RACE Score for the Prehospital Identification of Large Vessel Occlusion Stroke in a Suburban/Rural EMS Service Introduction: Emergency Medical Services (EMS) providers may identify and preferentially transport patients experiencing large vessel occlusion (LVO) stroke to appropriate treatment centers. The Rapid Arterial oCclusion Evaluation (RACE) scale was created for prehospital LVO detection, yet few studies have evaluated its function in real-world EMS settings. Our (...) objective was to assess the prehospital performance of the RACE scale for detecting LVO stroke following implementation at a large suburban/rural agency in the United States. Methods: In this retrospective analysis, all 9-1-1 patients with an EMS provider primary or secondary impression of stroke treated by the agency between June 1, 2016 and November 1, 2017 were eligible for inclusion. Patient data were abstracted using a standardized form completed by receiving hospitals. Performance for LVO

2019 EvidenceUpdates

79. Death From Stroke in End-Stage Kidney Disease

Death From Stroke in End-Stage Kidney Disease Background and Purpose- People with end-stage kidney disease (ESKD) are at greater risk of stroke. We aimed to compare stroke mortality between the ESKD population and the general population. Methods- We included all patients with incident ESKD in Australia, 1980 to 2013, and New Zealand, 1988 to 2012. The primary cause of death was ascertained using data linkage with national death registers. We produced standardized mortality ratios for stroke (...) deaths, by age, sex, and calendar year. Results- We included 60 823 patients with ESKD, where 941 stroke deaths occurred during 381 874 person-years. Patients with ESKD had >3× the stroke deaths compared with the general population (standardized mortality ratio, 3.4; 95% CI, 3.2-3.6), markedly higher in younger people and women. The greatest excess was in intracerebral hemorrhages (standardized mortality ratio, 5.2; 95% CI, 4.5-5.9). Excess stroke deaths in patients with ESKD decreased over time

2019 EvidenceUpdates

80. Priming With 1-Hz Repetitive Transcranial Magnetic Stimulation Over Contralesional Leg Motor Cortex Does Not Increase the Rate of Regaining Ambulation Within 3 Months of Stroke: A Randomized Controlled Trial. (PubMed)

Priming With 1-Hz Repetitive Transcranial Magnetic Stimulation Over Contralesional Leg Motor Cortex Does Not Increase the Rate of Regaining Ambulation Within 3 Months of Stroke: A Randomized Controlled Trial. The potential benefits of repetitive transcranial magnetic stimulation (rTMS), applied either alone or as a combination treatment, on recovery of lower limbs after stroke have been insufficiently studied.The aim of the study was to evaluate the effect of priming with 1-Hz repetitive (...) transcranial magnetic stimulation over contralesional leg motor area with a double-cone coil before physical therapy on regaining ambulation.Thirty-eight subacute stroke patients with significant leg disabilities were randomly assigned into the experimental group or control group to receive a 15-min real or sham 1-Hz repetitive transcranial magnetic stimulation, respectively, over the contralesional motor cortex representing the quadriceps muscle followed by 45-min physical therapy for 15 sessions for 3

2019 American journal of physical medicine & rehabilitation