Objective To assess the effect of naloxone in treating the disease of acute cerebral infarction. Methods Sixty patients of acute cerebral infarction were randomly divided into two groups. One group received routine therapy and the other routine therapy plus naloxone. Neuroprotective effect of naloxone were measured by using NIH stroke scale and Bathel-Index. Adverse effect of the drug was also observed. Results There were 27 patients (90%) improved with clinical manifestations in experiment group, and 20 patients (67%) improved in control group. There is a significant difference between the two groups (Plt;0.05).There is no adverse reactions of naxloxone observed. Conclusion Naloxone might protect the nervous cells and restore the function of the nervous system in patients with acute cerebral infraction.
Severe/massive ischaemic stroke is difficult to treat and has poor prognosis. There are limited studies for specific treatment of these conditions and no consensus on their definitions. This proposal suggests definitions and a flowchart for the diagnosis and treatment of these conditions. We focus on predicting and preventing malignant oedema at an early stage, monitoring the level of consciousness and vital signs, and the prevention and management of complications (eg. pulmonary infections). We particularly provide suggestions for the treatment with intravenous thrombolysis, endovascular treatment, antiplatelet and anticoagulation. More studies are warranted to support individualised management of infarct swelling, intracranial hypertension and early rehabilitation for severe/massive ischaemic stroke.
Massive cerebral infarction with malignant brain edema has poor prognosis with very high mortality, despite aggressive medical treatment. Surgical decompression is recommended by Chinese and international clinical guidelines for patients with massive cerebral infarction, however, there is no standardized diagnosis and treatment protocol in clinical practice. Following the principle of evidence-based medicine and based on the diagnosis and treatment norms of the participating hospitals of Severe Ischaemic Stroke Collaboration in recent years, we recommend this consensus statement of the standardized surgical decompression for malignant brain edema in massive cerebral infarction.