Information about Stroke:
Interview of Dr. Drauzio Varella with the neurologist and President of Rede Brasil AVC, Prof. Dr. Sheila Martins, who clarifies the main symptoms of stroke, how to proceed and the main treatments available: https://www.youtube.com/watch?v=8sVAla6hRqw
The routine of stroke treatment in the Stroke Unit of the Emergency Unit of the Hospital das Clínicas de Ribeirão Preto:
Report of the Fantástico Program that shows the routine of stroke treatment in the Stroke Unit of the Emergency Unit of the Hospital das Clínicas de Ribeirão Preto, under the coordination of Prof. Dr. Octavio Marques Pontes-Neto and Dr. Millene Rodrigues Camilo. Link to report:: https://g1.globo.com/fantastico/noticia/2019/11/03/fantastico-mostra-a-rotina-de-uma-emergencia-que-e-referencia-no-atendimento-as-vitimas-de-avc.ghtml
The rising number of young stroke patients:
Report of the Bem Star Program with Prof. Dr, Octavio Marques Pontes-Neto on the main risk factors for stroke, especially in young people: https://g1.globo.com/bemestar/noticia/2019/08/02/estilo-de-vida-aumenta-o-risco-de-avc-em-jovens.ghtml
Further Information
USP’s Newspaper – a section about Stroke and other Cerebrovascular Diseases
https://jornal.usp.br/tag/minuto-do-cerebro/
Rede Brasil AVC’s Site, tab ‘Para Pacientes e Familiares’ – Further information about stroke:
http://www.redebrasilavc.org.br/para-pacientes-e-falimiares/o-que-e-avc/
Ongoing Researches about Stroke
Several researches/trials are being carried out in Brazil and in the world to discover and compare one or more treatments for stroke. The goal is to offer the best treatment to the population affected by this disease. Below is a summary of each of these studies conducted by hospitals participating in the National Stroke Research Network.
BASICS – Basilar Artery International Cooperation Study: The BASICS trial is a multicentric clinical trial in which Brazilian hospitals take part. The aim is to analyze whether the endovascular treatment (a type of procedure in which a catheter is used that enters the femoral artery and goes to the brain) associated with the optimized clinical treatment (use of medicines, including the ones which ” break ” the thrombus that is preventing blood circulation in the brain) is more effective and safer than the best optimized clinical treatment in ischemic stroke caused by occlusion of the basilar artery. The main outcome is the application of a scale (Modified Rankin Scale) that assesses the patient’s functionality 90 days after the stroke.
More information about the trial:
http://www.basicstrial.com/Main.html
THALES – Acute STroke or Transient IscHaemic Attack Treated With TicAgreLor and ASA for PrEvention of Stroke and Death: This is also a study in which Brazilian hospitals participates. The objective is to analyze two medications: test the hypothesis that the drugs ticagrelor and acetylsalicylic acid (ASA) are superior to ASA alone in preventing stroke and death or in patients already with acute ischemic stroke (AIS) or stroke transient ischemic stroke (TIA).
More information about the trial:
https://clinicaltrials.gov/ct2/show/NCT03354429
“ETHICHS” – Esmolol for the Treatment of Hypertension after Intracerebral Hemorrhage Study : The objective is to compare the effect of adding the drug Esmolol to the current treatment used for the treatment of Hemorrhagic Stroke. Esmolol is a medication that controls the heart rate in people with atrial fibrillation or ‘cardiac arrhythmia’. That is, this study wants to analyze the effect of this medication in the treatment of hemorrhagic stroke compared to what is already done.
More information about the trial:
https://clinicaltrials.gov/ct2/show/NCT03743103?term=ETHICHS&cond=Stroke&draw=2&rank=1
OPTIMAL STROKE – Optimal Blood Pressure for the prevenTIon of Major vAscuLar Events in Stroke Patients: The primary objectives are to determine whether more intense blood pressure control in the stroke population impacts the reduction of major cardiovascular events and to determine whether an intensive pressure reduction strategy compared to standard treatment will produce a greater reduction in the incidence of total and event mortality (mortality from heart disease, non-fatal infarction, non-fatal stroke).
More information about the trial:
https://clinicaltrials.gov/ct2/show/NCT04036409
Sub trial – OPTIMAL MIND: It is a sub trial from the previous one. Some selected patients will undergo a test that evaluates the mental part, called MoCA. This test will be performed during the second month follow-up visit, the 24-month visit and the 48-month visit or at the end of the study. Patients who present altered scores in the cognitive screening test will be subjected to more complete tests.
TRIDENT – Triple therapy prevention of Recurrent Intracerebral Disease EveNts Trial. This is also a mulicentric trial in which Brazilian hospitals take part. The general objective is to analyze the effect of a drug that seeks to lower blood pressure more intensively after a hemorrhagic stroke. This study has two phases: 1: To determine the efficacy, tolerance, safety and adherence to a single low-dose pill and fixed combination with antihypertensive effect (Pill – telmisartan 20 mg, amlodipine 2.5 mg and indapamide 1, 25mg) compared to placebo in patients with recent acute stroke due to spontaneous intraparenchymal cerebral hemorrhage (HIP). Phase 2: Determine the effectiveness of the most intensive reduction in blood pressure (BP) provided by a strategy as a standard treatment, at the time of the first occurrence of recurrent stroke after intraparenchymal hemorrhage.
More information about the trial:
ELETRON TRIAL – Treatment of unilateral spatial neglect after stroke using transcranial direct current stimulation: The aim of this trial is to evaluate the effectiveness and safety of tDCS (transcranial direct current stimulation). It is a non-invasive treatment (it is not necessary to do any procedure that cuts or punctures it to perform it) for unilateral spatial neglect after ischemic or hemorrhagic stroke. The effects of this treatment can provide new ideas for health professionals and policy makers.
More information about the trial:
https://www.ncbi.nlm.nih.gov/pubmed/27716442
INTERACT-3 – The Third, Intensive Care Bundle With Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial : And a trial with the participation of Brazil and other countries. INTERACT3 aims to determine the effectiveness of a set of care directed to active management (intensive reduction of blood pressure, glycemic control, treatment of fever and reversal of anticoagulation ) compared to standard care in the treatment of a subtype of hemorrhagic stroke, which is intraparenchymal hemorrhage.
More information about the trial:
https://clinicaltrials.gov/ct2/show/NCT03209258