2014, Número 1
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Rev Cubana Neurol Neurocir 2014; 4 (1)
Ictus isquémico: avances y proyecciones
Rodríguez GPL
Idioma: Español
Referencias bibliográficas: 99
Paginas: 71-88
Archivo PDF: 1126.40 Kb.
RESUMEN
Objetivo: Presentar los principales aspectos novedosos y las proyecciones con respecto al manejo del ictus isquémico.
Desarrollo: Se enfoca el artículo hacia los aspectos recientemente tratados en las revistas especializadas sobre: 1) Las definiciones de los tipos de ictus, 2) Los factores genéticos de riesgo del ictus isquémico, 3) El paradigma de neuro–imagen en el ictus isquémico, 4) La telemedicina para el ictus (tele–ictus), 5) El uso de los antitrombóticos (terapia antiagregante oral dual, manejo periprocedimiento de los antitrombóticos, profilaxis con anticoagulantes orales de acción directa, extensión del tiempo de trombólisis a 4,5 horas después del debut), 6) La evolución de los enfoques hacia las técnicas endovasculares, 7)
El aporte de las células madres en el infarto cerebral, 8) Las terapias para el edema cerebral hemisférico maligno, 9) La regulación de las cifras de presión arterial en el ictus, y 10) La identificación de intervenciones farmacológicas (inhibidores selectivos de la recaptación de la serotonina) para ayudar a la recuperación motora.
Conclusiones: Se revisan los principales avances recientes realizados y las proyecciones para la investigación y el manejo en la práctica clínica del ictus isquémico. La consideración de los factores que limitan su introducción es crucial para perfeccionar el cuidado de los pacientes con ictus. Para implementar dichos avances se precisa del incremento de la conciencia y la educación pública sobre el ictus, el perfeccionamiento de los protocolos para los centros de ictus, el desarrollo de los procesos de certificación de los centros de ictus y de las capacidades de tele–ictus, y del soporte económico y legislativo.
REFERENCIAS (EN ESTE ARTÍCULO)
Rodríguez García PL. Estrategias para la prevención y control de las enfermedades cerebrovasculares. Rev Cubana Neurol Neurocir. [Internet] 2012 [citado 25.12.2013];2(1):63–86. Disponible en: http://www.revneuro.sld.cu/index.php/neu/article/view/26/190
Rodríguez García PL. Examen clínico del paciente con ictus. Rev Cubana Neurol Neurocir. [Internet] 2011 [citado 25.12.2013];1(1):74–89. Disponible en: http://www.revneuro.sld.cu/index.php/neu/article/view/12/136
Buergo Zuaznábar MA, Fernández concepción O. Guías de Prácticas clínicas para el ictus. La Habana: Ecimed; 2009.
Jauch EC, Saver JL, Adams HP Jr, Bruno A, Connors JJ, Demaerschalk BM, et al; American Heart Association Stroke Council; Council on Cardiovascular Nursing; Council on Peripheral Vascular Disease; Council on Clinical Cardiology. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44:870–94.
Rodríguez García PL, Rodríguez Pupo LR. Semiología Neurológica. La Habana: Ecimed; 2012.
Sacco R, Kasner S, Broderick J, Caplan L, Connors J, Culebras A, et al. An Updated Definition of Stroke for the 21st Century. Stroke. 2013;44:00–00. DOI: 10.1161/STR.0b013e318296aeca
Aho K, Harmsen P, Hatano S, Marquardsen J, Smirnov VE, Strasser T. Cerebrovascular disease in the community: results of a WHO collaborative study. Bull World Health Organ. 1980;58:113–30.
Easton JD, Saver JL, Albers GW, Alberts MJ, Chaturvedi S, Feldmann E, Hatsukami TS, Higashida RT, Johnston SC, Kidwell CS, Lutsep HL, Miller E, Sacco RL. Definition and evaluation of transient ischemic attack. Stroke. 2009;40:2276–93.
Bevan S, Traylor M, Adib–Samii P, Malik R, Paul NL, Jackson C, et al. Genetic heritability of ischemic stroke and the contribution of previously reported candidate gene and genomewide associations. Stroke. 2012;43(12):3161–7. doi: 10.1161/STROKEAHA.112.665760.
Flossmann E, Schulz UG, Rothwell PM. Systematic review of methods and results of studies of the genetic epidemiology of ischemic stroke. Stroke. 2004;35(1):212–27.
Adib–Samii P, Rost N, Traylor M, Devan W, Biffi A, Lanfranconi S, et al. 17q25 Locus is associated with white matter hyperintensity volume in ischemic stroke, but not with lacunar stroke status. Stroke. 2013;44(6):1609–15. doi: 10.1161/STROKEAHA.113.679936.
Dichgans M, Malik R, König IR, Rosand J, Clarke R, Gretarsdottir S, et al. Shared genetic susceptibility to ischemic stroke and coronary artery disease: a genome–wide analysis of common variants. Stroke. 2014;45(1):24–36. doi: 10.1161/STROKEAHA.113.002707.
Yadav S, Cotlarciuc I, Munroe PB, Khan MS, Nalls MA, Bevan S, et al. Genome–wide analysis of blood pressure variability and ischemic stroke. Stroke. 2013 Oct;44(10):2703–9. doi: 10.1161/STROKEAHA.113.002186.
Gudbjartsson DF, Arnar DO, Helgadottir A, Gretarsdottir S, Holm H, Sigurdsson A, et al. Variants conferring risk of atrial fibrillation on chromosome 4q25. Nature. 2007;448(7151):353–7.
Matarin M, Brown WM, Singleton A, Hardy JA, Meschia JF; ISGS investigators. Whole genome analyses suggest ischemic stroke and heart disease share an association with polymorphisms on chromosome 9p21. Stroke. 2008;39(5):1586–9. doi: 10.1161/STROKEAHA.107.502963.
Hillman MA, Wilke RA, Yale SH, Vidaillet HJ, Caldwell MD, Glurich I, et al. A prospective, randomized pilot trial of model–based warfarin dose initiation using CYP2C9 genotype and clinical data. Clin Med Res. 2005;3(3):137–45.
Anderson JL, Horne BD, Stevens SM, Grove AS, Barton S, Nicholas ZP, et al. Randomized trial of genotype–guided versus standard warfarin dosing in patients initiating oral anticoagulation. Circulation. 2007;116(22):2563–70.
Gorelick PB, Farooq MU. Advances in our understanding of "resistance" to antiplatelet agents for prevention of ischemic stroke. Stroke Res Treat. 2013;2013:727842. doi: 10.1155/2013/727842.
Dubey P, Pandey S, Moonis G. Acute stroke imaging: recent updates. Stroke Res Treat. 2013;2013:767212. doi: 10.1155/2013/767212.
Muir KW, Buchan A, von Kummer R, Rother J, Baron JC. Imaging of acute stroke. Lancet Neurol. 2006;5(9):755–68.
González RG. Low signal, high noise and large uncertainty make CT perfusion unsuitable for acute ischemic stroke patient selection for endovascular therapy. J Neurointerv Surg. 2012;4(4):242–5. doi: 10.1136/neurintsurg–2012–010404.
Dani KA, Thomas RG, Chappell FM, Shuler K, MacLeod MJ, Muir KW, et al. Computed tomography and magnetic resonance perfusion imaging in ischemic stroke: definitions and thresholds. Ann Neurol. 2011;70(3):384–401. doi: 10.1002/ana.22500.
Demchuk AM, Menon B, Goyal M. Imaging–based selection in acute ischemic stroke trials – a quest for imaging sweet spots. Ann N Y Acad Sci. 2012 Sep;1268:63–71. doi: 10.1111/j.1749–6632.2012.06732.x.
Warwick PJH, Barber PA, Hill MD, Sevick RJ, Demchuk AM, Hudon ME, et al. Use of the Alberta Stroke Program Early CT Score (ASPECTS) for assessing CT scans in patients with acute stroke. American Journal of Neuroradiology 2001; 22: 1534–42.
Gupta AC, Schaefer PW, Chaudhry ZA, Leslie–Mazwi TM, Chandra RV, González RG, et al. Interobserver reliability of baseline noncontrast CT Alberta Stroke Program Early CT Score for intra–arterial stroke treatment selection. AJNR Am J Neuroradiol. 2012;33(6):1046–9. doi: 10.3174/ajnr.A2942.
Spence JD. Atrial fibrillation and stroke prevention: is warfarin still an option? Yes: Debate at the Controversies in Neurology Congress, Beijing, October 2011. J Neural Transm. 2013;120(10):1447–51. doi: 10.1007/s00702–012–0941–5.
Liebeskind DS, Sanossian N, Yong WH, Starkman S, Tsang MP, Moya AL, Zheng DD, et al. CT and MRI early vessel signs reflect clot composition in acute stroke. Stroke. 2011;42(5):1237–43. doi: 10.1161/STROKEAHA.110.605576.
González RG. Clinical MRI of acute ischemic stroke. J Magn Reson Imaging. 2012;36(2):259–71. doi: 10.1002/jmri.23595.
Thomalla G, Hartmann F, Juettler E, Singer OC, Lehnhardt FG, Köhrmann M, et al. Prediction of malignant middle cerebral artery infarction by magnetic resonance imaging within 6 hours of symptom onset: A prospective multicenter observational study. Ann Neurol. 2010;68(4):435–45. doi: 10.1002/ana.22125.
Yoo AJ, Barak ER, Copen WA, Kamalian S, Gharai LR, Pervez MA, et al. Combining acute diffusion–weighted imaging and mean transmit time lesion volumes with National Institutes of Health Stroke Scale Score improves the prediction of acute stroke outcome. Stroke. 2010;41(8):1728–35. doi: 10.1161/STROKEAHA.110.582874.
Yoo AJ, Chaudhry ZA, Nogueira RG, Lev MH, Schaefer PW, Schwamm LH, et al. Infarct volume is a pivotal biomarker after intra–arterial stroke therapy. Stroke. 2012;43(5):1323–30. doi: 10.1161/STROKEAHA.111.639401.
Kidwell CS, Jahan R, Gornbein J, Alger JR, Nenov V, Ajani Z, et al. A trial of imaging selection and endovascular treatment for ischemic stroke. N Engl J Med. 2013;368(10):914–23. doi: 10.1056/NEJMoa1212793.
Huisa BN, Neil WP, Schrader R, Maya M, Pereira B, Bruce NT, et al. Clinical use of computed tomographic perfusion for the diagnosis and prediction of lesion growth in acute ischemic stroke. J Stroke Cerebrovasc Dis. 2014;23(1):114–22. doi: 10.1016/j.jstrokecerebrovasdis.2012.10.020.
Lev MH. Perfusion imaging of acute stroke: its role in current and future clinical practice. Radiology. 2013;266(1):22–7. doi: 10.1148/radiol.12121355.
Zhu G, Michel P, Aghaebrahim A, Patrie JT, Xin W, Eskandari A, et al. Computed tomography workup of patients suspected of acute ischemic stroke: perfusion computed tomography adds value compared with clinical evaluation, noncontrast computed tomography, and computed tomography angiogram in terms of predicting outcome. Stroke. 2013;44(4):1049–55. doi: 10.1161/STROKEAHA.111.674705.
Campbell BC, Christensen S, Levi CR, Desmond PM, Donnan GA, Davis SM, Parsons MW. Cerebral blood flow is the optimal CT perfusion parameter for assessing infarct core. Stroke. 2011;42(12):3435–40. doi: 10.1161/STROKEAHA.111.618355.
Kamalian S, Kamalian S, Maas MB, Goldmacher GV, Payabvash S, Akbar A, et al. CT cerebral blood flow maps optimally correlate with admission diffusion–weighted imaging in acute stroke but thresholds vary by postprocessing platform. Stroke. 2011;42(7):1923–8. doi: 10.1161/STROKEAHA.110.610618.
Mlynash M, Lansberg MG, De Silva DA, Lee J, Christensen S, Straka M, et al. Refining the definition of the malignant profile: insights from the DEFUSE–EPITHET pooled data set. Stroke. 2011;42(5):1270–5. doi: 10.1161/STROKEAHA.110.601609.
Bang OY, Saver JL, Kim SJ, Kim GM, Chung CS, Ovbiagele B, et al. Collateral flow averts hemorrhagic transformation after endovascular therapy for acute ischemic stroke. Stroke. 2011;42(8):2235–9. doi: 10.1161/STROKEAHA.110.604603.
Souza LC, Yoo AJ, Chaudhry ZA, Payabvash S, Kemmling A, Schaefer PW, et al. Malignant CTA collateral profile is highly specific for large admission DWI infarct core and poor outcome in acute stroke. AJNR Am J Neuroradiol. 2012;33(7):1331–6. doi: 10.3174/ajnr.A2985.
González RG, Lev MH, Goldmacher GV, Smith WS, Payabvash S, Harris GJ, et al. Improved outcome prediction using CT angiography in addition to standard ischemic stroke assessment: results from the STOPStroke study. PLoS One. 2012;7(1):e30352. doi: 10.1371/journal.pone.0030352.
Pulli B, Schaefer PW, Hakimelahi R, Chaudhry ZA, Lev MH, Hirsch JA, González RG, Yoo AJ. Acute ischemic stroke: infarct core estimation on CT angiography source images depends on CT angiography protocol. Radiology. 2012;262(2):593–604. doi: 10.1148/radiol.11110896.
Liman TG, Winter B, Waldschmidt C, Zerbe N, Hufnagl P, Audebert HJ, Endres M. Telestroke ambulances in prehospital stroke management: concept and pilot feasibility study. Stroke. 2012;43(8):2086–90. doi: 10.1161/STROKEAHA.112.657270.
Audebert HJ, Schwamm L. Telestroke: scientific results. Cerebrovasc Dis. 2009;27 Suppl 4:15–20. doi: 10.1159/000213054.
Johansson T, Wild C. Telemedicine in acute stroke management: systematic review. Int J Technol Assess Health Care. 2010;26(2):149–55. doi: 10.1017/S0266462310000139.
Handschu R, Scibor M, Willaczek B, Nückel M, Heckmann JG, Asshoff D, et al. Telemedicine in acute stroke: remote video–examination compared to simple telephone consultation. J Neurol. 2008;255(11):1792–7. doi: 10.1007/s00415–008–0066–9.
Demaerschalk B. Telestrokologists: Treating Stroke Patients Here, There, and Everywhere with Telemedicine. Semin Neurol 2010;30:477–91.
Moskowitz A, Chan YF, Bruns J, Levine SR. Emergency physician and stroke specialist beliefs and expectations regarding telestroke. Stroke. 2010;41(4):805–9. doi: 10.1161/STROKEAHA.109.574137.
Switzer JA, Hall CE, Close B, Nichols FT, Gross H, Bruno A, Hess DC. A telestroke network enhances recruitment into acute stroke clinical trials. Stroke. 2010 Mar;41(3):566–9. doi: 10.1161/STROKEAHA.109.566844.
Bergrath S, Reich A, Rossaint R, Rörtgen D, Gerber J, Fischermann H, et al. Feasibility of prehospital teleconsultation in acute stroke––a pilot study in clinical routine. PLoS One. 2012;7(5):e36796. doi: 10.1371/journal.pone.0036796.
Cheng–Ching E, Samaniego EA, Naravetla B, Zaidat O, Hussain M. Update on pharmacology of antiplatelets, anticoagulants, and thrombolytics. Neurology 2012;79 (Suppl 1):S68–S76.
Wang Y, Wang Y, Zhao X, Liu L, Wang D, Wang C, et al; CHANCE Investigators. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N Engl J Med. 2013;369:11–9.
SPS3 Investigators, Benavente OR, Hart RG, et al. Effects of clopidogrel added to aspirin in patients with recent lacunar stroke. N Engl J Med. 2012;367:817–25.
Palacio S, Hart RG, Pearce LA, Anderson DC, Sharma M, Birnbaum LA, Benavente OR. Effect of addition of clopidogrel to aspirin on stroke incidence: Meta–analysis of randomized trials. Int J Stroke. 2013. doi: 10.1111/ijs.12050.
Armstrong MJ, Gronseth G, Anderson DC, Biller J, Cucchiara B, Dafer R, et al. Summary of evidence–based guideline: Periprocedural management of antithrombotic medications in patients with ischemic cerebrovascular disease Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013;80:2065–9.
Hart R, Pogue J, Eikelboom J. Direct–Acting Oral Anticoagulants The Brain Gets a Break. JAMA Neurology. 2013;70(12):1483–4. doi:10.1001/jamaneurol.2013.4347.
Bauer KA. Pros and cons of new oral anticoagulants. Hematology Am Soc Hematol Educ Program. 2013;2013:464–70. doi: 10.1182/asheducation–2013.1.464.
Wallentin L, Yusuf S, Ezekowitz MD, Alings M, Flather M, Franzosi MG, et al. Efficacy and safety of dabigatran compared with warfarin at different levels of international normalized ratio control for stroke prevention in atrial fibrillation: an analysis of the RE–LY trial. Lancet. 2010;376:975–83.
Chatterjee S, Sardar P, Bion di–Zoccai G, Kumbhani DJ. New oral anticoagulants and the risk of intracranial hemorrhage: traditional and Bayesian meta–analysis and mixed treatment comparison of randomized trials of new oral anticoagulants in atrial fibrillation. JAMA Neurol. 2013;70(12):1486–90. doi:10.1001/jamaneurol.2013.4021
Kirmani JF, Alkawi A, Panezai S, Gizzi M. Advances in thrombolytics for treatment of acute ischemic stroke. Neurology. 2012;79;S119–S125. DOI 10.1212/WNL.0b013e3182695882
Taqi M, Vora N, Callison R, Lin R, Wolfe T. Past, present, and future of endovascular stroke therapies. Neurology. 2012;79;S213–S220.
Ciccone A, del Zoppo GJ. Evolving role of endovascular treatment of acute ischemic stroke. Curr Neurol Neurosci Rep. 2014;14(1):416. doi: 10.1007/s11910–013–0416–6.
Jadhav AP, Jovin TG. Intra–arterial reperfusion strategies in acute ischemic stroke. J Neurointerv Surg. 2013;5 Suppl 1:i66–9. doi: 10.1136/neurintsurg–2013–010739.
Mokin M, Snyder KV, Levy EI, Hopkins LN, Siddiqui AH. Direct carotid artery puncture access for endovascular treatment of acute ischemic stroke: technical aspects, advantages, and limitations. J Neurointerv Surg. 2014. doi: 10.1136/neurintsurg–2013–011007.
Kidwell CS, Jahan R, Alger JR, Schaewe TJ, Guzy J, Starkman S, et al. Design and rationale of the Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy (MR RESCUE) Trial. Int J Stroke. 2014;9(1):110–6. doi: 10.1111/j.1747–4949.2012.00894.x.
Lazzaro M, Novakovic R, Alexandrov A, Darkhabani Z, Edgell R, English J, et al. Developing practice recommendations for endovascular revascularization for acute ischemic stroke. Neurology. 2012;79;S243–S255.
Serrone JC, Jimenez L, Ringer AJ. The role of endovascular therapy in the treatment of acute ischemic stroke. Neurosurgery. 2014;74 Suppl 1:S133–41. doi: 10.1227/NEU.0000000000000224.
Mokin M, Khalessi AA, Mocco J, Lanzino G, Dumont TM, Hanel RA, et al. Endovascular treatment of acute ischemic stroke: the end or just the beginning? Neurosurg Focus. 2014;36(1):E5. doi: 10.3171/2013.10.FOCUS13374.
Fiehler J, Söderman M, Turjman F, White PM, Bakke SJ, Mangiafico S, et al. Future trials of endovascular mechanical recanalisation therapy in acute ischemic stroke patients: a position paper endorsed by ESMINT and ESNR: part I: Current situation and major research questions. Neuroradiology. 2012;54(12):1293–301. doi: 10.1007/s00234–012–1075–z.
Hill MD, Brooks W, Mackey A, Clark WM, Meschia JF, Morrish WF, et al. Stroke after carotid stenting and endarterectomy in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST). Circulation. 2012 Dec 18;126(25):3054–61. doi: 10.1161/CIRCULATIONAHA.112.120030.
Timaran CH, Mantese VA, Malas M, Brown OW, Lal BK, Moore WS, Voeks JH, Brott TG; CREST Investigators. Differential outcomes of carotid stenting and endarterectomy performed exclusively by vascular surgeons in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST). J Vasc Surg. 2013 Feb;57(2):303–8. doi: 10.1016/j.jvs.2012.09.014.
Paraskevas KI, Mikhailidis DP, Liapis CD, Veith FJ. Critique of the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST): flaws in CREST and its interpretation. Eur J Vasc Endovasc Surg. 2013 Jun;45(6):539–45. doi: 10.1016/j.ejvs.2013.03.014.
Liu X, Ye R, Yan T, Yu SP, Wei L, Xu G, et al. Cell based therapies for ischemic stroke: From basic science to bedside. Prog Neurobiol. 2013 Dec 12. pii: S0301–0082(13)00131–7. doi: 10.1016/j.pneurobio.2013.11.007.
Oki K, Tatarishvili J, Wood J, Koch P, Wattananit S, Mine Y, et al. Human–induced pluripotent stem cells form functional neurons and improve recovery after grafting in stroke–damaged brain. Stem Cells. 2012;30(6):1120–33. doi: 10.1002/stem.1104.
Chang DJ, Oh SH, Lee N, Choi C, Jeon I, Kim HS, et al. Contralaterally transplanted human embryonic stem cell– derived neural precursor cells (ENStem–A) migrate and improve brain functions in stroke–damaged rats. Exp Mol Med. 2013 Nov 15;45:e53. doi: 10.1038/emm.2013.93.
Misra V, Ritchie M, Stone L, Low W, Janardhan V. Stem cell therapy in ischemic stroke: Role of IV and intra–arterial therapy. Neurology. 2012;79;S207–S212.
Savitz SI, Chopp M, Deans R, Carmichael ST, Phinney D, Wechsler L. Stem Cell Therapy as an Emerging Paradigm for Stroke (STEPS) II. Stroke 2011;42:825–9.
Wang LQ, Lin ZZ, Zhang HX, Shao B, Xiao L, Jiang HG, et al. Timing and Dose Regimens of Marrow Mesenchymal Stem Cell Transplantation Affect the Outcomes and Neuroinflammatory Response After Ischemic Stroke. CNS Neurosci Ther. 2014. doi: 10.1111/cns.12216.
Huttner HB, Schwab S. Malignant middle cerebral artery infarction: clinical characteristics, treatment strategies, and future perspectives. Lancet Neurol. 2009;8(10):949–58.
Vahedi K, Hofmeijer J, Juettler E, Vicaut E, George B, Algra A, et al. Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials. Lancet Neurol. 2007;6(3):215–22.
Yu JW, Choi JH, Kim DH, Cha JK, Huh JT. Outcome following decompressive craniectomy for malignant middle cerebral artery infarction in patients older than 70 years old. J Cerebrovasc Endovasc Neurosurg. 2012 Jun;14(2):65–74. doi: 10.7461/jcen.2012.14.2.65.
Arac A, Blanchard V, Lee M, Steinberg GK. Assessment of outcome following decompressive craniectomy for malignant middle cerebral artery infarction in patients older than 60 years of age. Neurosurg Focus. 2009 Jun;26(6):E3. doi: 10.3171/2009.3.FOCUS0958.
Kamel H, Navi BB, Nakagawa K, Hemphill JC, Ko NU. Hypertonic saline versus mannitol for the treatment of elevated intracranial pressure: a meta–analysis of randomized clinical trials. Critical Care Medicine. 2011;39(3):554–9.
Singh V, Edwards NJ. Advances in the critical care management of ischemic stroke. Stroke Res Treat. 2013;2013:510481. doi: 10.1155/2013/510481.
Simard JM, Chen M, Tarasov KV, Bhatta S, Ivanova S, Melnitchenko L, et al. Newly expressed SUR1–regulated NCCa–ATP channel mediates cerebral edema after ischemic stroke. Nat Med. 2006;12(4):433–40.
Simard JM, Tsymbalyuk N, Tsymbalyuk O, Ivanova S, Yurovsky V, Gerzanich V. Glibenclamide is superior to decompressive craniectomy in a rat model of malignant stroke. Stroke. 2010;41(3):531–7.
Khanna A, Walcott BP, Kahle KT, Simard JM. Effect of glibenclamide on the prevention of secondary brain injury following ischemic stroke in humans. Neurosurg Focus. 2014;36(1):E11. doi: 10.3171/2013.10.FOCUS13404.
Sheth KN, Kimberly WT, Elm JJ, Kent TA, Mandava P, Yoo AJ, et al. Pilot study of intravenous glyburide in patients with a large ischemic stroke. Stroke. 2014;45(1):281–3. doi: 10.1161/STROKEAHA.113.003352.
Sandset EC, Bath PM, Boysen G, Jatuzis D, Kõrv J, Lüders S, et al. The angiotensin–receptor blocker candesartan for treatment of acute stroke (SCAST): a randomised, placebo–controlled, double–blind trial. The Lancet. 2011;377(9767):741–750.
Chollet F, Tardy J, Albucher JF, Thalamas C, Berard E, Lamy C, et al. Fluoxetine for motor recovery after acute ischaemic stroke (FLAME): a randomised placebo–controlled trial. Lancet Neurol. 2011;10(2):123–30. doi: 10.1016/S1474–4422(10)70314–8.
Fernández Concepción O, Marrero Fleita M, Mesa Barrero Y, Santiesteban Velázquez N, Rojas Fuentes J. Rev Cubana Neurol Neurocir. [Internet] 2012 [citado 25.12.2013];2(1):9–16. Disponible en: http://www.revneuro.sld.cu/index.php/neu/article/view/31
Dhami KS, Churchward MA, Baker GB, Todd KG. Fluoxetine and citalopram decrease microglial release of glutamate and D–serine to promote cortical neuronal viability following ischemic insult. Mol Cell Neurosci. 2013;56:365–74. doi: 10.1016/j.mcn.2013.07.006.
Cramer SC. Listening to fluoxetine: a hot message from the FLAME trial of poststroke motor recovery. Int J Stroke. 2011;6(4):315–6. doi: 10.1111/j.1747–4949.2011.00618.x.
Mead GE, Hsieh CF, Lee R, Kutlubaev MA, Claxton A, Hankey GJ, Hackett ML. Selective serotonin reuptake inhibitors (SSRIs) for stroke recovery. Cochrane Database Syst Rev. 2012;11:CD009286. doi: 10.1002/14651858.CD009286.pub2.
Chollet F, Cramer SC, Stinear C, Kappelle LJ, Baron JC, Weiller C, et al. Pharmacological therapies in post stroke recovery: recommendations for future clinical trials. J Neurol. 2013 Nov 13. [Epub ahead of print] http://dx.doi.org/10.1007/s00415–013–7172–z
Chollet F, Albucher JF. Strategies to augment recovery after stroke. Curr Treat Options Neurol. 2012;14(6):531–40. doi: 10.1007/s11940–012–0196–3.
Wu C, Lin K, Wolf S, Roby–Brami A. Motor Rehabilitation after Stroke. Stroke Res Treat. 2012;2012:810706. http://dx.doi.org/10.1155/2012/810706
Iosa M, Morone G, Fusco A, Bragoni M, Coiro P, Multari M, et al. Seven Capital Devices for the Future of Stroke Rehabilitation. Stroke Res Treat. 2012;2012:187965. http://dx.doi.org/10.1155/2012/187965
Sale P, Lombardi V, Franceschini M. Hand robotics rehabilitation: feasibility and preliminary results of a robotic treatment in patients with hemiparesis. Stroke Res Treat. 2012;2012:820931. doi: 10.1155/2012/820931.