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Articles by Jason P Appleton
Blood Pressure in Acute Stroke
One of the oldest questions in acute stroke management, and perhaps the most challenging since it has yet to be solved after more than half a century of published research, is how to manage high blood pressure (BP). The problem might be summed up as follows: To treat, or not to treat: that is the question: Whether ’tis nobler in the mind to suffer The slings and arrows of outrageous pressure, Or to take drugs against a sea of blood, And by opposing end them?
Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial
In this trial of tranexamic acid versus placebo after acute intracerebral haemorrhage, there was no significant difference between the groups in the primary outcome of functional status at day 90.
Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial - The Lancet
In this cohort of patients with acute, non-cardioembolic ischaemic stroke or TIA, a regimen of intensive antiplatelet therapy did not reduce stroke recurrence or its severity when compared with guideline antiplatelet therapy with either clopidogrel alone or combined aspirin and dipyridamole. However, intensive antiplatelet therapy was associated with both more, and more severe, bleeding.
PP18 Interim analysis of ambulance logistics and timings in patients recruited into the rapid intervention with glyceryl trinitrate in hypertensive stroke trial-2 (right-2) | Emergency Medicine Journal
Background Stroke is a severe condition with high morbidity and mortality. Despite treatment effects in acute stroke being predominantly time dependent (e.g. thrombolysis and thrombectomy), proven treatments are hospital based and require prior brain scanning to identify intracerebral haemorrhage. Commencing treatment in the ambulance could dramatically reduce time to treatment.
Management of acute intracerebral haemorrhage - an update
Managing acute intracerebral haemorrhage is a challenging task for physicians. Evidence shows that outcome can be improved with admission to an acute stroke unit and active care, including urgent reversal of anticoagulant effects and, potentially, intensive blood pressure reduction.
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