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European stroke org...
European stroke organisation (ESO) guideline on cerebral small vessel disease, part 2, lacunar ischaemic stroke
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- Wardlaw, Joanna M. (author)
- University of Edinburgh
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- Chabriat, Hugues (author)
- Lariboisière Hospital
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- de Leeuw, Frank Erik (author)
- Radboud University Medical Center
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- Debette, Stéphanie (author)
- Centre Hospitalier Universitaire de Bordeaux,University of Bordeaux
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- Dichgans, Martin (author)
- German Centre for Cardiovascular Research,German Center for Neurodegenerative Diseases (DZNE), Bonn,University Hospital Munich,Munich Cluster for Systems Neurology
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- Doubal, Fergus (author)
- University of Edinburgh
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- Jokinen, Hanna (author)
- Helsinki University Central Hospital
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- Katsanos, Aristeidis H. (author)
- Population Health Research Institute, Ontario
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- Ornello, Raffaele (author)
- University of L'Aquila
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- Pantoni, Leonardo (author)
- Luigi Sacco University Hospital
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- Pasi, Marco (author)
- University Of Tours
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- Pavlovic, Aleksandra M. (author)
- University of Belgrade
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- Rudilosso, Salvatore (author)
- Hospital Clínic of Barcelona
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- Schmidt, Reinhold (author)
- Medical University of Graz
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- Staals, Julie (author)
- Maastricht University Medical Centre
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- Taylor-Rowan, Martin (author)
- University of Glasgow
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- Hussain, Salman (author)
- European Stroke Organisation
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- Lindgren, Arne G. (author)
- Lund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Klinisk strokeforskning,Forskargrupper vid Lunds universitet,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical Stroke Research Group,Lund University Research Groups
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(creator_code:org_t)
- English.
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In: European Stroke Journal. - 2396-9873.
- Related links:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Subject headings
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- A quarter of ischaemic strokes are lacunar subtype, typically neurologically mild, usually resulting from intrinsic cerebral small vessel pathology, with risk factor profiles and outcome rates differing from other stroke subtypes. This European Stroke Organisation (ESO) guideline provides evidence-based recommendations to assist with clinical decisions about management of lacunar ischaemic stroke to prevent adverse clinical outcomes. The guideline was developed according to ESO standard operating procedures and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. We addressed acute treatment (including progressive lacunar stroke) and secondary prevention in lacunar ischaemic stroke, and prioritised the interventions of thrombolysis, antiplatelet drugs, blood pressure lowering, lipid lowering, lifestyle, and other interventions and their potential effects on the clinical outcomes recurrent stroke, dependency, major adverse cardiovascular events, death, cognitive decline, mobility, gait, or mood disorders. We systematically reviewed the literature, assessed the evidence and where feasible formulated evidence-based recommendations, and expert concensus statements. We found little direct evidence, mostly of low quality. We recommend that patients with suspected acute lacunar ischaemic stroke receive intravenous alteplase, antiplatelet drugs and avoid blood pressure lowering according to current acute ischaemic stroke guidelines. For secondary prevention, we recommend single antiplatelet treatment long-term, blood pressure control, and lipid lowering according to current guidelines. We recommend smoking cessation, regular exercise, other healthy lifestyle modifications, and avoid obesity for general health benefits. We cannot make any recommendation concerning progressive stroke or other drugs. Large randomised controlled trials with clinically important endpoints, including cognitive endpoints, are a priority for lacunar ischaemic stroke.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- alteplase
- antihypertensive
- antiplatelet
- Guideline
- lacunar stroke
- lipid lowering
- small vessel disease
- stroke
- systematic review
- thrombolysis
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Wardlaw, Joanna ...
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Chabriat, Hugues
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de Leeuw, Frank ...
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Debette, Stéphan ...
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Dichgans, Martin
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Doubal, Fergus
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Jokinen, Hanna
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Katsanos, Ariste ...
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Ornello, Raffael ...
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Pantoni, Leonard ...
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Pasi, Marco
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Pavlovic, Aleksa ...
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Rudilosso, Salva ...
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Schmidt, Reinhol ...
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Staals, Julie
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Taylor-Rowan, Ma ...
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Hussain, Salman
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Lindgren, Arne G ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
- Articles in the publication
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European Stroke ...
- By the university
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Lund University