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Therapie des ischämischen Insults

  • P. Ringleb
  • E. Orberk
  • T. Brandt
  • W. Hacke

Zusammenfassung

In den letzten Jahren hat sich die Auffassung durchgesetzt, dass ein Patient mit einem Schlaganfall ebenso ein dringlicher Notfall ist wie Patienten mit akutem Myokardinfarkt. Dies beruht nicht zuletzt auf den positiven Resultaten der systemischen Lysetherapie aus den letzten Jahren. Hiermit steht erstmals eine wirkliche Therapie mit der Chance der Reversibilität des neurologischen Defizits zur Verfügung. Die Behandlung des Schlaganfallpatienten muss sich seither nicht mehr nur auf allgemeine stabilisierende Maßnahmen beschränken [46, 82].

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Literatur

  1. 1.
    Adams HP Jr, Brott TG, Crowell RM, Furlan AJ, Gomez CR, Grotta J, Helgason CM, Marier JR, Woolson RF, Zivin JA, et al. (1994) Guidelines for the management of patients with acute ischemic stroke. A statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke 25:1901–1914Google Scholar
  2. 2.
    Alexandrov AV, Black SE, Ehrlich LE, Caldwell CB, Norris JW (1997) Predictors of hemorrhagic transformation occuring spontaneously and on anticoagulants in patients with acute ischemic stroke. Stroke 28:1198–1202PubMedCrossRefGoogle Scholar
  3. 3.
    Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi-Filho G, Kairalla RA, Deheinzelin D, Munoz C, Oliveira R, Takagaki TY, Carvalho CR (1998) Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med 338:347–354PubMedCrossRefGoogle Scholar
  4. 4.
    Angeleri F, Scarpino O, Martinazzo C et al. (1992) GM1 ganglioside therapy in acute ischemie stroke. Cerbrovascular Disorders 2:163–168CrossRefGoogle Scholar
  5. 5.
    Argentino C, Sacchetti ML, Toni D, Savoini G, D’Arcangelo E, Erminio F, Federico F, Milone FF, Gallai V, Gambi D (1989) GM1 ganglioside therapy in acute ischemie stroke. Stroke 20:1143–1149Google Scholar
  6. 6.
    Asconapé JJ, Penry JK (1991) Poststroke seizures in the elderly. Clin Geriatr Med 7:483–492PubMedGoogle Scholar
  7. 7.
    Astrup J, Siesjö B, Symon L (1981) Thresholds in cerebral ischemia — the ischemie penumbra. Stroke 12:723–725PubMedCrossRefGoogle Scholar
  8. 7a.
    Barer DH (1988) The natural history and consequences of dysphagia after hemispheric stroke. J Neurol Neurosurg Psychiatry 52:236–241CrossRefGoogle Scholar
  9. 8.
    Berlit P, Busse O, Diener HC, Haberl RL, Hacke W, Harms L, Kaps M, Kessler C, Ringelstein B (1996) Empfehlungen für die Einrichtung von Schlagan-fallspezialstationen. Akt Neurologie 23:171–175CrossRefGoogle Scholar
  10. 9.
    Berlit P, Busse O, Diener HC, Haberl RL, Hacke W, Harms L, Kaps M, Kessler C, Ringelstein B (1997) Empfehlungen für die Einrichtung von Schlagan-fallspezialstationen — Aktualisierung 1997. Akt Neurologie 24:XXV–XXXGoogle Scholar
  11. 11.
    Bousser MG (1997) Aspirin or heparin immediately after a stroke? Lancet 349:1564–1565PubMedCrossRefGoogle Scholar
  12. 12.
    Brandt T, von Kummer R, Müller Kuppers M, Hacke W (1996) Thrombolytic therapy of acute basilar artery occlusion. Variables affecting recanali-zation and outcome. Stroke 27:875–881PubMedCrossRefGoogle Scholar
  13. 13.
    Brass LM, Lichtmann JH, Ceres J, Krumholz HM (1998) Management of stroke among academic medical centers (Abstract). Stroke 29:312Google Scholar
  14. 14.
    Britton M, Carlsson A, de Faire U (1986) Blood pressure course in patients with acute stroke and matched controls. Stroke 17:861–864PubMedCrossRefGoogle Scholar
  15. 15.
    Brott T, Fieschi C, Hacke W (1994) General Therapy of Acute Ischemie Stroke. In: Hacke W (Hrsg) Neurocritical Care. Springer, Heidelberg pp 377–553Google Scholar
  16. 16.
    Brott T, Kothari R, Barsan W, Tomsick T, Sauerbeck L, Spilker J, Duldner J, Khouri J (1997) Early hemorrhage growth in patients with intracerebral hemorrhage. Stroke 28:1–5PubMedCrossRefGoogle Scholar
  17. 17.
    Brott T, Haley EC Jr, Levy DE, Barsan W, Broderick J, Sheppard GL, Spilker J, Kongable GL, Massey S, Reed R, et al. (1992) Urgent therapy for stroke. Part I. Pilot study of tissue plasminogen activator administered within 90 minutes. Stroke 23:632–640PubMedCrossRefGoogle Scholar
  18. 18.
    Bullough DA, Zhang C, Montag A, Mullane KM, Young MA (1994) Adenosine-mediated inhibition of platelet aggregation by acadesine: a novel antithrombotic mechanism in vitro and in vivo. J Clin Invest 94:1524–1532PubMedCrossRefGoogle Scholar
  19. 19.
    Camerlingo M, Casto L, Censori B, Ferraro B, Gazzaniga GC, Cesana B, Mamoli A (1994) Immediate anticoagulation with heparin for first-ever ischemic stroke in the carotid artery territories observed within 5 hours of onset. Arch Neurol 51:462–467PubMedCrossRefGoogle Scholar
  20. 20.
    Carter AJ (1994) Many agents that antagonize the NMDA receptor channel complex in vivo also cause disturbance of motor coordination. J Pharmacol Exp Ther 269:573–580PubMedGoogle Scholar
  21. 21.
    Cerebral Embolism Study Group (1983) Immediate anticoagulation of embolic stroke: a randomized trial. Stroke 14:668–676CrossRefGoogle Scholar
  22. 22.
    Chinese Acute Stroke Trial Collaborative Group (1997) CAST: randomised placebo-controlled trial of early aspirin use in 20000 patients with acute ischaemic stroke. Lancet 349:1641–1649CrossRefGoogle Scholar
  23. 23.
    Choi DW (1994) Calcium and excitotoxic neuronal injury. Ann NY Acad Sci 747:164–171Google Scholar
  24. 24.
    Davis SM, Albers GW, Diener HC (1997) Termination of acute stroke studies involving selfotel treatment. Lancet 349:32PubMedCrossRefGoogle Scholar
  25. 25.
    Dawson VL, Dawson TM, London ED (1991) Nitric oxide mediates glutamate neurotoxicity in primary cortical culture. Proc Nat Acad Sci USA 88:6368–6371PubMedCrossRefGoogle Scholar
  26. 26.
    De Deyn PP, De Reuck J, Deberedt W, Vlietinck R, Orgogozo J-M for the PASS Group (1997) Treatment of acute ischemie stroke with piracetam. Stroke 28:2347–2352PubMedCrossRefGoogle Scholar
  27. 27.
    del Zoppo GJ, Higashida RT, Furlan AJ, Pessin MS, Rowley HA, Gent M (1998) PROACT: A Phase II Randomized Trial of Recombinant Pro-Urokinase by Direct Arterial Delivery in Acute Middle Cerebral Artery Stroke. Stroke 29:4–11PubMedCrossRefGoogle Scholar
  28. 28.
    del Zoppo GJ, Poeck K, Pessin MS, Wolpert SM, Furlan AJ, Ferbert A, Alberts MJ, Zivin JA, Wechsler L, Busse O, Greenlee Jr. R, Brass L, Mohr JP, Feldmann E, Hacke W, Kase CS, Biller J, Gress D, Otis SM (1992) Recombinant tissue plasminogen activator in acute thrombotic and embolie stroke. Ann Neurol 32:78–86PubMedCrossRefGoogle Scholar
  29. 29.
    Diener HC, Hacke W, Hennerici M, Radberg J (1996) for the Lubeluzole International Study Group: Lubeluzole in acute ischemie stroke: A double-blind, placebo-controlled phase II trial. Stroke 27:76–81PubMedCrossRefGoogle Scholar
  30. 30.
    Donnan GA, Davis SM, Chambers BR, Gates PC, Hankey GJ, McNeil JJ, Rosen D, Stewart-Wynne EG, Tuck RR (1995) Trials of streptokinase in severe acute ischaemic stroke. Lancet 345:578–579PubMedCrossRefGoogle Scholar
  31. 31.
    D’Orlando KL, Sandage BJ (1995) Citicoline (CDP-choline): Mechanisms of action and effects in inschemic brain injury. Neurol Res 17:281–284Google Scholar
  32. 32.
    Duke RJ, Bloch RF, Turpie AGG, Trebilcock R, Bayer N (1986) Intravenous heparin for the prevention of stroke progression in acute partial stabile stroke: A randomized controlled trial. Ann Intern Med 105:825–828PubMedGoogle Scholar
  33. 33.
    Einhäupl KM, Masuhr F (1999) Acute therapy of stroke. Fortsch Med 117(3):26–31Google Scholar
  34. 34.
    Fieschi C, Argentino C, Lenzi GL, Fantozzi L, Sacchetti ML, Pace A, Rasura M, Bastianello S, Bozzao L, Zanette E, et al. (1988) Therapeutic window for pharmacological treatment in acute focal cerebral ischemia. Ann N Y Acad Sci 522:662–666PubMedCrossRefGoogle Scholar
  35. 35.
    Fisher M, Do T, Weiss J, Trubetskoy V, Charette M, Finkelstein S (1995) Delayed treatment with intravenous basic fibroblast growth factor reduces infarct size following permanent focal cerebral ischemia in rats. J Cerebral Blood Flow Metab 15:935–959CrossRefGoogle Scholar
  36. 36.
    Frey JL, Greene KA, Khayata MH (1995) Intra-thrombus Administration of tissue plasminogen activator in acute cerebrovascular occlusion. Angiology 46:649–656PubMedCrossRefGoogle Scholar
  37. 37.
    Fujikawa M, Kamiike W, Hatanaka N, Shimizu S, Akashi A, Miyata M, Kurosawa K, Yoshida Y, Tagawa K, Matsuda H (1994) Changes in biliary glutathione level during ischemia-reperfusion of rat liver. J Surg Res 57:569–573PubMedCrossRefGoogle Scholar
  38. 38.
    Garthwaite J, Charles SL, Chess-Williams R (1988) Endothelium-derived relaxing factor release on activation of NMDA receptor suggests its role as intercellular messenger in the brain. Nature 336:385–388PubMedCrossRefGoogle Scholar
  39. 39.
    Glenn MB, Whyte J (1990) The practical management of spasticity in children and adults. Lea & Febiger, Philadelphia, LondonGoogle Scholar
  40. 40.
    Graham SH, Chen J, Lan J, Leach MJ, Simon RP (1994) Neuroprotective effects of a use-dependent blocker of voltage dependent sodium channels, BW619C89, in rat middle cerebral artery occlusion. J Pharmacol Exp Ther 269:854–859PubMedGoogle Scholar
  41. 41.
    Grau AJ, Buggle F, Hacke W (1996) Body temperature and infection in acute stroke. Lancet 347:1415–1416PubMedCrossRefGoogle Scholar
  42. 42.
    Grond M, Stenzel C, Schmulling S, Rudolf J, Neveling M, Lechleuthner A, Schneweis S, Heiss WD (1998) Early intravenous thrombolysis for acute ischemic stroke in a community-based approach. Stroke 29:1544–1549PubMedCrossRefGoogle Scholar
  43. 43.
    Gross CE, Bednar MM, Howard DB, Sporn MB (1993) Transforming growth factor-beta 1 reduces infarct size after experimental cerebral ischemia in a rabbit model. Stroke 24:558–5562PubMedCrossRefGoogle Scholar
  44. 44.
    Hacke W, del Zoppo GJ, Furlan A, von Kummer R (1995) Ischemie Stroke. In: Hanley DF (Hrsg) Principles and Practices in Neurocritical Care. Williams & Wilkins, BaltimoreGoogle Scholar
  45. 45.
    Hacke W, Kaste M, Fieschi C, Toni D, Lesaffre E, von Kummer R, Boysen G, Bluhmki E, Höxter G, Mahagne M-H (1995) Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke, The European Cooperative Acute Stroke Study (ECASS). JAMA 274:1017–1025PubMedCrossRefGoogle Scholar
  46. 46.
    Hacke W, Kaste M, Fieschi C, von Kummer R, Davalos A, Meier D, Larrue V, Bluhmki E, Davis S, Donnan G, Scheider D, Diez-Tejedor E, Trouilas P (1998) Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke. Lancet 352:1245–1251PubMedCrossRefGoogle Scholar
  47. 47.
    Hacke W, Schwab S, De Georgia M (1995) Intensive Care of Acute Ischemic Stroke. Cerebrovasc Disorders 4:385–392CrossRefGoogle Scholar
  48. 48.
    Hacke W, Stingele R, Steiner T, Schuchardt V, Schwab S (1996) Critical care of acute ischemic stroke. Intensive Care Med 10:856–862Google Scholar
  49. 49.
    Hacke W, Zeumer H, Ferbert A, Brückmann H, DelZoppo G (1988) Intraarterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke 19:1216–1222PubMedCrossRefGoogle Scholar
  50. 50.
    Haley EC, Jr., Kassell NF, Torner JC (1988) Failure of heparin to prevent progression in progressing ischemie infarction. Stroke 19:10–14PubMedCrossRefGoogle Scholar
  51. 51.
    Haley EC, Jr., Levy DE, Brott TG, Sheppard GL, Wong MC, Kongable GL, Torner JC, Marier JR (1992) Urgent therapy for stroke. Part II. Pilot study of tissue plasminogen activator administered 91-180 minutes from onset. Stroke 23:641–645PubMedCrossRefGoogle Scholar
  52. 52.
    Haley EC (1997) for the Glaxo Wellcome North American GAIN Investigators: Glycine Antagonist in Neuroprotection-1 (GAIN-1). Abstract. In: 22nd Int Joint Conf on Stroke and Cerebral Circulation, American Heat Association Vol. CT3, p2: AnaheimGoogle Scholar
  53. 53.
    Hankey GJ, Hon C (1997) Surgery for primary intracerebral hemorrhage: is it safe and effective? A systematic review of case series and randomized trials. Stroke 28:2126–2132PubMedCrossRefGoogle Scholar
  54. 54.
    Hardisty et al. (1990) The action of ticlopidine on human platelets: Studies on aggregation, secretion, calcium mobilization and membrane glycoproteins. Thromb Haemost 64:150–155PubMedGoogle Scholar
  55. 54a.
    Henon H, Lebert F, Durieu I, Godefroy O, Lucas C, Pasquier F, Leys D (1999) Confusional state in stroke: relation to preexisting dementia, patient characteristics, and outcome. Stroke 30(4):773–779PubMedCrossRefGoogle Scholar
  56. 55.
    Hilker R, Zakzuk M, Schneweis S, Rudolf J, Jacobs A, Neveling M (1999) Nosokomiale Pneumonie nach akutem ischämischen Hirninsult: Evaluation von Inzidenz und Risikofaktoren in der neurologischen Intensivmedizin. Intensivmedizin und Notfallmedizin (in press)Google Scholar
  57. 56.
    Hossman KA (1988) Pathophysiology of cerebral infarction. In: Vinken PJ, Bruyn GW, Klawans HL (Hrsg) Handbook of Neurology, Vol. 53. Elsevier, pp 107–153Google Scholar
  58. 57.
    Hossman KA (1994) Glutamate-mediated injury in focal cerebral ischemia: the excitotoxin hypothesisi revised. Brain Pathology 4:23–36CrossRefGoogle Scholar
  59. 58.
    Huber W, Willmes K, Poeck K, van Vleymen B, Debert W (1997) Piracetam as an adjuvant to language therapy for aphasia: a randomized double-blind placebo-controlled pilot study. Arch Phys Med Rehabil 78:245–250PubMedCrossRefGoogle Scholar
  60. 59.
    International Stroke Trial Collaborative Group (1997) The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both or neither among 19435 patients with acute ischaemic stroke. Lancet 349:1569–1581CrossRefGoogle Scholar
  61. 60.
    Italian Acute Stroke Study Group (1988): Hemodi-lution in acute stroke: results of the Italian Hemodilution Trial. Lancet: 318–321Google Scholar
  62. 61.
    Jansen O, Schellinger PD, Fiebach JB, Hacke W, Sartor K (1999) Early recanalization in acute ischemie stroke saves tissue at risk defined by MRI. Lancet 353:2036–2037PubMedCrossRefGoogle Scholar
  63. 62.
    Jansen O, von Kummer R, Forsting M, Hacke W, Sartor K (1995) Thrombolytic therapy in acute occlusion of the intracranial internal carotid artery bifurcation. AJNR 16:1977–1986PubMedGoogle Scholar
  64. 63.
    Jaenecke J (1996) Antikoagulanzientherapie und Fibrinolysetherapie. Thieme, 5. AuflageGoogle Scholar
  65. 64.
    Kaufmann AM, Cardoso ER (1992) Aggravation of vasogenic cerebral edema by multiple-dose mannitol J Neurosurg 77:584–589PubMedCrossRefGoogle Scholar
  66. 65.
    Kay R, Wong KS, Yu YL, Chan YW, Tsoi TH, Ahuja AT, Chan FL, Fong KY, Law CB, Wong A (1995) Low-molecular-weight heparin for the treatment of acute ischemie stroke. N Engl J Med 333:24: 1588–1593PubMedCrossRefGoogle Scholar
  67. 66.
    Kofier M, Kronenberg MF, Rifici C, Saltuari L, Bauer G (1994) Epileptic seizures associated with intrathecal baclofen application. Neurology 44:25–27CrossRefGoogle Scholar
  68. 67.
    Larrue V, von Kummer R, del Zoppo G, Bluhmki E (1997) Hemorrhagic transformation in acute ischemie stroke: potential contributing factors in the european cooperative acute stroke study. Stroke 28:957–960PubMedCrossRefGoogle Scholar
  69. 68.
    MacHale SM, O’Rourke SJ, Wardlaw JM, Dennis MS (1998) Depression and its relation to lesion location after stroke. J Neurol Neurosurg Psychiatry 64:371–374PubMedCrossRefGoogle Scholar
  70. 69.
    Marsh 3rd EE, Adams HP, Biller J, Wasek P, Banwart K, Mitchell V, Woolson R (1989) Use of antithrombotic drugs in the treatment of acute ischemie stroke: A survey of neurologists in practice in the United States. Neurology 39:1631–1634PubMedCrossRefGoogle Scholar
  71. 70.
    Marshall J, Shaw DA (1960) Anticoagulant therapy in acute cerebrovascular accidents: a controlled trial. Lancet 995–998Google Scholar
  72. 71.
    Meden P, Overgaard K, Pedersen H, Boysen G (1996) Effect of early treatment with tirilazad (U74006F) combined with delayed thrombolytic therapy in rat embolie stroke. Cerebrovasc Dis 6:141–148CrossRefGoogle Scholar
  73. 72.
    Mohr JP, Orgogozo JM Harrison M (1994) Metaanalysis of oral nimodipine trials in acute ischemie stroke. Cerebrovasc Dis 4:204–210CrossRefGoogle Scholar
  74. 73.
    Mori E, Yoneda Y, Tabuchi M, Yoshida T, Ohkawa S, Ohsumi Y, Kitano K, Tsutsumi A, Yamadori A (1992) Intravenous recombinant tissue plasminogen activator in acute carotid artery territory-stroke. Neurology 42:976–982PubMedCrossRefGoogle Scholar
  75. 74.
    Muir KW, Lees KR (1995) A randomized, double-blind, placebo-controlled pilot trial of intravenous magnesium sulfate in acute stroke. Stroke 26:1183–1188PubMedCrossRefGoogle Scholar
  76. 75.
    Muir KW, Lees KR (1996) Clinical experience with excitatory amino acid antagonist drugs. Stroke 26:503–513CrossRefGoogle Scholar
  77. 77.
    Muizelaar JP, Marmarou A, Ward JD, Kontos HA, Choi SC, Becker DP, Gruemer H, Young HF (1991) Adverse effects of prolonged hyperventilation in patients with severe head injury. A randomized clinical trial. J Neurosurg 75:731–739PubMedCrossRefGoogle Scholar
  78. 78.
    Multicenter Acute Stroke Trial — Europe Study Group (1996) Thrombolytic Therapy with streptokinase in acute ischaemic stroke. N Engl J Med 335:145–150CrossRefGoogle Scholar
  79. 79.
    Multicentre Acute Stroke Trial — Italy (MAST-I) Group (1995) Randomized controlled trial of streptokinase, aspirin, and combination of both in treatment of acute ischaemic stroke. Lancet 356:1509–1514Google Scholar
  80. 80.
    Nakanishi S, Shneider NA, Axel R (1990) A familiy of glutamate receptor genes: evidence for the formation heteromultimeric receptors with distinct channel properties. Neuron 5:569–581PubMedCrossRefGoogle Scholar
  81. 81.
    Nakayama N, Ginsberg M, Dietrich WD (1988) (S)-emopamil, a novel calcium channel blocker and serotonin S2 antagonist, markedly reduces infarct size following middle cerebral artery occlusion in the rat. Neurology 38:1667–1673PubMedCrossRefGoogle Scholar
  82. 82.
    NIH-Group (1996) Tissue Plasminogen Activator for Acute Ischemic Stroke. N Eng J Med 333:1581–1587Google Scholar
  83. 83.
    Olney JW (1994) Neurotoxicity of NMDA receptor antagonists: an overview. Psychopharmacol Bull 30:533–540PubMedGoogle Scholar
  84. 84.
    Peinemann A, Stefan H (1998) Alterepilepsie. Nervenarzt 69:110–116PubMedCrossRefGoogle Scholar
  85. 85.
    Petty GW, Brown RD, Whisnant JP, Sicks JD, O’Fallon WM, Wiebers DO (1999) Frequency of major complications of aspirin, warfarin, and intravenous heparin for secondary stroke prevention. Ann Intern Med 130:14–22PubMedGoogle Scholar
  86. 86.
    Phillis JW (1989) Adenosine in the control of the cerebral circulation. Crebrovasc Brain Metab Revue 1:26–54Google Scholar
  87. 87.
    Pickard JD, Czosnyka M (1993) Management of raised intracranial pressure. J Neurol Neurosurg Psychiatry 56:845–858PubMedCrossRefGoogle Scholar
  88. 88.
    Prehn JH, Welsch M, Backhauss C, Nuglisch J, Ausmeier F, Karkoutly C, Krieglstein J (1993) Effects of serotoninergic drugs in experimental brain ischemia: evidence for a protective role of serotonin in cerebral ischemia. Brain Research 630:10–20PubMedCrossRefGoogle Scholar
  89. 89.
    PROACT II Investigators (1999) PROACT II: Re-combinant prourokinase (r-ProUK) in Acute Cerebral Thromboembolism. Initial Trial Results. 24th American Heart Association International Conference on Stroke and Cerebral Circulation, Nashville, Tennessee, USAGoogle Scholar
  90. 90.
    Pulsinelli W (1992) Pathophysiology of acute ischaemic stroke. Lancet 339:16–19CrossRefGoogle Scholar
  91. 91.
    Ramirez-Lassepas M, Quinones MR, Nino HH (1986) Treatment of acute ischemic stroke. Open trial with continuous intravenous heparinization. Arch Neurol 43:386–390PubMedCrossRefGoogle Scholar
  92. 92.
    Raschke RA, Reilly BM, Guidry JR (1993) The weight-based heparin dosing nomogram compared with a „standard care“ nomogram. Ann Intern Med 119:874–881PubMedGoogle Scholar
  93. 93.
    Ringelstein EB, Busse O, Grond M (1999) Akutversorgung von Patienten mit zerebralen Insulten. D Arztebl 35:B-875–877Google Scholar
  94. 94.
    Ringleb PA, Bertram M, Keller E, Hacke W (1998) Hypertension in patients with cerebrovascular accident. To treat or not to treat? Nephrol Dial Transpant 13:2179–2181PubMedGoogle Scholar
  95. 95.
    Ronning OM, Guldvog B (1997) Stroke Unit Versus General Medical Wards, I: Twelve-and Eighteen-Month Survival. Stroke 29:58–62CrossRefGoogle Scholar
  96. 96.
    Sacco RL, Foulkes MA, Mohr JP, Wolf PA, Hier DB, Price TTR (1989) Determinants of early recurrence of cerebral infarction: Stroke Data Bank. Stroke 20:983–989PubMedCrossRefGoogle Scholar
  97. 97.
    Sacco RL, Shi T, Zamanillo MC, Kargman DE (1994) Predictors of mortality and recurrence after hospitalized cerebral infarction in an urban community: The Northern Manhattan Stroke Study. Neurology 44:626–634PubMedCrossRefGoogle Scholar
  98. 98.
    Sandercock PA, van den Belt AG, Lindley RI, Slattery J (1993) Antithrombotic therapy in acute ischaemic stroke: an overview of the completed randomised trials. J Neurol Neurosurg Psychiatry 56:17–25PubMedCrossRefGoogle Scholar
  99. 99.
    Scandinavian Stroke Study Group (1987) Multicenter trial of hemodilution in acute ischemie stroke. Results in the total patient population. Stroke 18:691–699CrossRefGoogle Scholar
  100. 100.
    Schellinger P, Jansen O, Fiebach J, Hacke W, Sartor K (1999) A standardized MRI stroke protocol: comparison with CT in hyperacute intracerebral hemorrhage. Stroke 30:765–768PubMedCrossRefGoogle Scholar
  101. 102.
    Schmidt JF, Waldemar G (1990) Effect of nimodipine on cerebral blood flow in human volunteers. J Cardiovasc Pharmacol 16:568–571PubMedCrossRefGoogle Scholar
  102. 104.
    Schwab S, Spranger M, Aschof A, Steiner T, Hacke W (1997) Brain temperature monitoring and modulation in patients with severe MCA infarction. Neurology 48:762–767PubMedCrossRefGoogle Scholar
  103. 105.
    Schwab S, Schwarz S, Spranger M, Keller E, Bertram M, Hacke W (1998) Efficacy and safety of moderate hypothermia in the therapy of patients with acute MCA stroke. Stroke 29:2461–2466PubMedCrossRefGoogle Scholar
  104. 107.
    Schwab S, Spranger M, Schwarz S, Hacke W (1998) Barbiturate coma in patients with severe ischemie stroke: useful or obsolete? Neurology 48:1608–1613CrossRefGoogle Scholar
  105. 108.
    Schwab S, Steiner T, Aschoff A, Schwarz S, Steiner HH, Jansen O, Hacke W (1998) Early hemicra-niectomy in patients with complete middle cerebral artery infarction. Stroke 29:1888–1893PubMedCrossRefGoogle Scholar
  106. 109.
    Scriabine A, Schuurman T, Traber J (1989) Pharmacological basis for the use of nimodipine in central nervous system disorders. FASEB Journal 3:1799–1806PubMedGoogle Scholar
  107. 110.
    Siesjö BK (1994) Calcium-mediated processes in neuronal degeneration. Ann NY Acad Sci 747:140–161PubMedCrossRefGoogle Scholar
  108. 111.
    Silver SL, Norris JW, Lewis AJ, Hachinski VC (1984) Early mortality following stroke: A prospective review. Stroke 15:492–496PubMedCrossRefGoogle Scholar
  109. 112.
    Small DL, Buchan AM (1996) Mechanims of cerebral ischemia: intracellular cascades and therapeutic interventions. J Cardiothoracic Vascular Anesthesia 10:139–146CrossRefGoogle Scholar
  110. 113.
    Smithard DG, O’Neill PA, Park C, Morris J, Wyatt R, England R, Martin DF (1996) Complications and outcome after acute stroke: Does dysphagia matter? Stroke 27:1200–1204PubMedCrossRefGoogle Scholar
  111. 114.
    So EL, Annegers JF, Hauser WA, O’Brien PC, Whisnant JP (1996) Population-based study of seizure disorders after cerebral infarction. Neurology 46:350–355PubMedCrossRefGoogle Scholar
  112. 115.
    Starkstein SE, Robinson RG (1989) Affective disorders and cerebral vascular disease. Br J Psychiatry 154:170–182PubMedCrossRefGoogle Scholar
  113. 116.
    Steiner T, Bluhmki E, Kaste M, Toni D, Trouillas P, von Kummer R, Hacke W (1998) The ECASS 3-hour cohort. Secondary analysis of ECASS data by time stratification. Cerebrovasc Dis 8:198–203PubMedCrossRefGoogle Scholar
  114. 11.
    Steiner T, Schwab S, Hacke S (1999) Zerebrovas-kuläre Notfälle. In: Buchardi L (ed) Intensivmedizin. Springer, Heidelberg BerlinGoogle Scholar
  115. 118.
    Sydserff SD, Cross AJ, Green AR (1995) The neuro-protective effect of chlormethiazole on ischemic neuronal damage following permanent cerebral artery occlusion in the rat. Neurodegeneration 4:323–328PubMedCrossRefGoogle Scholar
  116. 11.
    The ATLANTIS Stroke Study Investigators (1999) The ATLANTIS rt-PA (Alteplase) acute stroke trial: final results. 24th American Heart Association International Conference on Stroke and Cerebral Circulation, Nashville, Tennessee, USAGoogle Scholar
  117. 12.
    The FISS bis Investigators Group (1998) Fraxiparine in ischemie stroke study. Cerebrovasc Dis 8[Suppl 4]:64Google Scholar
  118. 121.
    The Hemodilution in Stroke Study Group (1989) Hypervolemic Hemodilution Treatment of Acute Stroke. Results of a Randomized Multicenter Trial Using Pentastarch. Stroke 20:317–323CrossRefGoogle Scholar
  119. 12.
    The Japanese Thrombolysis in Stroke Group (1993) Intravenous tissue plasminogen activator ameliorates the outcome of hyperacute embolie stroke. Cerebrovasc Dis 3:269CrossRefGoogle Scholar
  120. 123.
    The Publications Committee for the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) Investigators (1998) Low molecular weight heparinoid, ORG 10172 (danaparoid), and outcome after acute ischemie stroke: a randomized controlled trial. JAMA 279:1265–1272CrossRefGoogle Scholar
  121. 124.
    The Stroke Prevention in Reversible Ischemia Trial (SPIRIT) Study Group (1997) A randomized trial of anticoagulants versus aspirin after cerebral ischemia of presumed arterial origin. Ann Neurol 42:857–865CrossRefGoogle Scholar
  122. 12.
    Treiman DM, Meyers PD, Walton NY, Collins JF, Colling C, Rowan AJ, Handforth A, Faught E, Ca-labrese VP, Uthman BM, Ramsay RE, Mamdani MB (1998) A comparison of four treatments for generalized convulsive status epilepticus. Veterans Affairs Status Epilepticus Cooperative Study Group. N Engl J Med 339(12):792–798PubMedCrossRefGoogle Scholar
  123. 126.
    van der Worp HB, Kappelle LJ (1998) Complications of acute ischemie stroke. Cerebrovasc Dis 8:124–132PubMedCrossRefGoogle Scholar
  124. 127.
    Vingerhoets F, Bogousslavsky J, Regli F, Van Mell G (1993) Atrial fibrillation after acute stroke. Stroke 24:26–30PubMedCrossRefGoogle Scholar
  125. 12.
    von Kummer R, Bozzao L, Manelfe C (Eds) (1995) Early CT diagnosis of hemispheric brain infarction. Springer, BerlinGoogle Scholar
  126. 129.
    von Kummer R, Hacke W (1992) Safety and efficacy of intravenous tissue plasminogen activator and heparin in acute middle cerebral artery stroke. Stroke 23:646–652CrossRefGoogle Scholar
  127. 13.
    Wahlgren NG (1997) The Clomethiazole Acute Stroke Study (CLASS). II Results of a randomized controlled study of clomethiazole versusu placebo in 545 acute stroke patients classified as total anterior circulation syndrome (TACS). (abstract). Cerebrovasc Dis 7:19Google Scholar
  128. 131.
    Wahlgren NG for the INWEST study group (1994) INWEST-study. Cerebrovasc Dis 4:204–210CrossRefGoogle Scholar
  129. 132.
    Ward JD, Becker DP, Miller JD, Choi SC, Marmarou A, Wood C, Newlon PG, Keenan R (1985) Failure of prophylactic barbiturate coma in the treatment of severe head injury. J Neurosurg 62:383–388PubMedCrossRefGoogle Scholar
  130. 133.
    Wijdicks EFM, Jack CR (1993) Intracerebral hemorrhage after fibrinolytic therapy for acute myocardial infarction. Stroke 24:554–557PubMedCrossRefGoogle Scholar
  131. 134.
    Wildermuth S, Knauth M, Brandt T, Winter R, Sartor K, Hacke W (1998) Role of CT angiography in patient selection for thrombolytic therapy in acute hemispheric stroke. Stroke 29:935–938PubMedCrossRefGoogle Scholar
  132. 135.
    Wolf PA, Abbott RD, Kannel WB (1991) Atrial fibrillation as an independent risk factor for stroke: The framingham Study. Stroke 22:983–988PubMedCrossRefGoogle Scholar
  133. 136.
    Yanaka K, Spellman SR, McCarthy JB, Oegema TR, Low WC, Camarata PJ (1996) Reduction of brain injury using heparin to inhibit leukocyte accumulation in a rat model of transient focal cerebral ischemia. I Protective mechanisms. J Neurosurg 85:1102–1107PubMedCrossRefGoogle Scholar
  134. 137.
    Yatsu FM, Zivin J (1985) Hypertension in Acute Ischemie Stroke: Not to Treat. Arch Neurology 42:999–1000CrossRefGoogle Scholar
  135. 13.
    Zaloga G, Roberts P (1997) Early enterai feeding improves outcome. In: Vincent JL (Hrsg) Yearbook of intensive care and emergency medicine. SpringerGoogle Scholar
  136. 139.
    Zeumer H, Freitag HJ, Zanella F, Thie A, Arning C (1993) Local intra-arterial fibrinolytic therapy in patients with stroke: urokinase versus recombinant tissue plasminogen activator (r-TPA). Neuroradiology 35:159–162PubMedCrossRefGoogle Scholar
  137. 140.
    Zornow HM, Prough DS (1996) Neuroprotective properties of calcium-channel blockers. New Horizons 4:100–114Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • P. Ringleb
  • E. Orberk
  • T. Brandt
  • W. Hacke

There are no affiliations available

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