PMID- 30986702
OWN - NLM
STAT- MEDLINE
DCOM- 20200824
LR  - 20200824
IS  - 1878-5883 (Electronic)
IS  - 0022-510X (Linking)
VI  - 401
DP  - 2019 Jun 15
TI  - Can we stop the stuttering in stroke? Interventions in 40 patients with acute 
      lacunes.
PG  - 1-4
LID - S0022-510X(19)30166-2 [pii]
LID - 10.1016/j.jns.2019.04.009 [doi]
AB  - BACKGROUND: Whether any treatment can stop fluctuations of stuttering lacunar 
      syndromes (SLS) is unclear. Case reports have variably suggested effectiveness of 
      intravenous thrombolysis, dual antiplatelet treatment, blood pressure 
      augmentation and anticoagulation. We aim to describe our experience with 
      different treatments used in in patients presenting with SLS and their effect on 
      clinical fluctuations and functional outcome. METHODS: We collected demographic 
      and clinical data of consecutive adult patients with SLS. Descriptive summaries 
      were reported as median and inter-quartile range (IQR) for continuous variables 
      and as frequencies and percentages for categorical variables. RESULTS: Forty 
      patients (72 +/- 10 years, 36% female) were included. Pure motor syndrome (57%) was 
      the most frequent clinical presentation. Clinical fluctuations stopped and the 
      improvement was temporally related to aspirin-clopidogrel in 11/17 cases, 
      intravenous thrombolysis in 4/6 cases, blood pressure augmentation in 1/3 cases 
      and aspirin in 1/7 cases. Two patients continued fluctuating after IVT and later 
      responded to blood pressure augmentation (n = 1) or aspirin-clopidogrel (n = 1). 
      CONCLUSIONS: Aspirin plus clopidogrel may be followed by clinical improvement 
      when intravenous thrombolysis is not an option. Blood pressure augmentation may 
      beneficial as ad-on treatment in patients with labile blood pressure.
CI  - Copyright (c) 2019 Elsevier B.V. All rights reserved.
FAU - Hawkes, Maximiliano A
AU  - Hawkes MA
AD  - Departments of Neurology and Internal Medicine, FLENI, Buenos Aires, Argentina. 
      Electronic address: mhawkes@fleni.org.ar.
FAU - Braksick, Sherri A
AU  - Braksick SA
AD  - Department of Neurology, University of Kansas Medical Center, Kansas City, KS, 
      United States of America.
FAU - Zhang, Wei
AU  - Zhang W
AD  - Department of Neurology, Division of Critical Care Neurology, Mayo Clinic, 
      Rochester, MN, United States of America.
FAU - Wijdicks, Eelco F M
AU  - Wijdicks EFM
AD  - Department of Neurology, Division of Critical Care Neurology, Mayo Clinic, 
      Rochester, MN, United States of America.
FAU - Rabinstein, Alejandro A
AU  - Rabinstein AA
AD  - Department of Neurology, Division of Critical Care Neurology, Mayo Clinic, 
      Rochester, MN, United States of America.
LA  - eng
PT  - Journal Article
DEP - 20190406
PL  - Netherlands
TA  - J Neurol Sci
JT  - Journal of the neurological sciences
JID - 0375403
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - A74586SNO7 (Clopidogrel)
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Aspirin/*administration & dosage
MH  - Blood Pressure/drug effects/physiology
MH  - Clopidogrel/*administration & dosage
MH  - Cohort Studies
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Male
MH  - Platelet Aggregation Inhibitors/*administration & dosage
MH  - Retrospective Studies
MH  - Stroke, Lacunar/*diagnostic imaging/*drug therapy
MH  - Tissue Plasminogen Activator/*administration & dosage
OTO - NOTNLM
OT  - Capsular warning
OT  - Cerebrovascular disease
OT  - Stroke
OT  - Stuttering
EDAT- 2019/04/16 06:00
MHDA- 2020/08/25 06:00
CRDT- 2019/04/16 06:00
PHST- 2019/02/16 00:00 [received]
PHST- 2019/04/02 00:00 [revised]
PHST- 2019/04/05 00:00 [accepted]
PHST- 2019/04/16 06:00 [pubmed]
PHST- 2020/08/25 06:00 [medline]
PHST- 2019/04/16 06:00 [entrez]
AID - S0022-510X(19)30166-2 [pii]
AID - 10.1016/j.jns.2019.04.009 [doi]
PST - ppublish
SO  - J Neurol Sci. 2019 Jun 15;401:1-4. doi: 10.1016/j.jns.2019.04.009. Epub 2019 Apr 
      6.