Ischemic Stroke

Sign/Symptoms
Aphasia (Difficulty Speaking or Comprehending Language) Behaviour: Personality Changes Coma Dizziness Dizziness or a Spinning Sensation (Vertigo) Eye: Vision Impairment Eyelid Drooping (Ptosis) Headache (Cephalgia) Loss of Consciousness (Unconsciousness) Memory Loss: Forgetfulness Mind: Confusion Movement: Muscle Coordination Loss (Ataxia) Muscle Weakness Partial Paralysis of One Side of The Body (Hemiparesis) Poor Balance (Imbalance) Skin Tingling Or Numbness (Paresthesias) Swallowing Difficulty (Dysphagia)

Drugs
Alteplase Papaverine Telmisartan

Treatments
Medical Procedure Hyperbaric Oxygen Therapy (HBOT) Weakly Against Moderate Evidence Alternative Medicine Pine Bark Weakly in Favour Low Evidence Alternative Therapies Acupuncture Weakly in Favour Very Low Evidence Qigong No Recommendation Very Low Evidence

Attributes
CriticalCare = Yes

Further Tests
Cerebrospinal Fluid Lactic Acid Concentration (L-Lactate) Lactic Acid (Cerebrospinal Fluid, L-Lactate) (Increased) Cerebrospinal Fluid Lactic Dehydrogenase Concentration Cerebrospinal Fluid Lactate Dehydrogenase (Increased) Cerebrospinal Fluid Protein Electrophoresis Alpha-1-Globulin (Cerebrospinal Fluid, CSF) (Increased) Alpha-2-Globulin (Cerebrospinal Fluid, CSF) (Increased) Gamma-Globulin (Cerebrospinal Fluid, CSF) (Increased) Oligoclonal Bands (Cerebrospinal Fluid, CSF) (Increased) Cerebrospinal Fluid White Cell Differential Cerebrospinal Fluid Leukocytes (Increased) Creatine Kinase Concentration Creatine Kinase (CK) (Increased) Fibrinogen Concentration test Fibrinogen (Increased) Homocysteine Concentration (HCY, Blood) Homocysteine (Increased) Lactic Acid Concentration Lactic Acid (Venous Blood) (Increased) Prolactin Concentration Prolactin (Decreased) Triglyceride (TGs) Concentration Triglycerides (Decreased) Urine Volume Urine (Increased)

Ischemic Stroke

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Pine Bark Extract [1, 2, 3, 4]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: weakly in favor (Early studies indicate potential for Pine bark extract in the treatment of strokes, but more clinical studies need to be done)

Grade of Evidence: low quality of evidence

Red Pepper (Capsaicin):

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: weak against (Available evidence does not support claims that Red Peppers help to treat or prevent strokes in any way)

Grade of Evidence: low quality of evidence

Hyperbaric Oxygen Therapy (HBOT):

NOT RECOMENDED

Recommendation: weakly against (Available evidence does NOT support claims that HBOT helps to treat stroke in any way)

Grade of Evidence: Moderate quality of evidence

Acupuncture:

Recommendation: weakly in favor (Although evidence is not strong, studies have shown that Acupuncture can help in the supportive care and rehabilitation of stroke patients. It is, however, NOT a treatment for stroke)

Grade of Evidence: very low quality of evidence

Qigong:

Recommendation: no recommendation (there is insufficient evidence to show that Qigong can help treat Angina in any way)

Grade of Evidence: very low quality of evidence

* www.gradeworkinggroup.org

Summary References

Treatments:

1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

2. http://www.clinicaltrials.gov/ct/show/NCT00214032

3. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/pine-bark-extract

4. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-pycnogenol.html

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