RESUMEN
Background: steroids therapy remains controversial for the patients with stroke, but some physicians administrate it yet, in such a patient. For this reason, in a double-blind clinical trail, we evaluated the dexamethasone effects on the motor function of the patients with stroke
Materials and methods: in a double-blind clinical trail, and in contrast to placebo, eighty patients presented with hemiplagia and with the impression of stroke enrolled in two groups that received dexamethasone and placebo. In the first admission day, the patients evaluated for risk factors, muscle force, level of consciousness, sphincter and speech disorders. Muscle forces reevaluated for five days later. All the data extracted with a checklist and compared by descriptive statistics and x2, t test, Mann-Whitney, Friedman and repeated measure ANOVA tests
Results: four patients excluded from the study for death. The age mean was 67.93+/-8.84 and 39 and 37 were male and female respectively. Except for sex and smoking, there was no difference in two groups. The muscle forces improved significantly in the patients in each groups [P value=0.000], but we didn't find any difference between them [P value=0.59]. Also we didn't see any steroid complication
Conclusion: this study failed to demonstrate any benefit of dexamethasone in improving the motor function of stroke patients
RESUMEN
Transcranial Doppler sonography [TCD] is a noninvasive, inexpensive, timesaving and portable imaging modality for localizing cerebral arterial pathology in patients with acute stroke especially in middle cerebral artery [MCA]. The present study was aimed to evaluate the predictive value of MCA hemodynamics status for recovery outcomes one and six months after the first appearance of the disease. This a prospective study was performed on 102 patients with cerebral ischemia who referred to Sina hospital of Hamadan in 1384. TCD was done during 24 hours after the admission along with routine medical management. Patients with previous stroke, head trauma, death and unknown diagnosis were excluded. The patients were divided into three groups based on their TCD. The first group, those with normal symmetric blood flow, the second one, those with decreased non-symmetric blood flow and the third, those with decreased symmetric blood flow of MCA. The physical examinations were repeated one and six months later and the outcomes were recorded. Using Cruscal-Vali statistical test, the data were analyzed. The mean of age in the patients was 65.39 +/- 12.67 and 48% of them were male. The motor function was improved significantly in the three groups [p<0.05]. After six months, the patient of group two had a better clinical improvement compared with groups one and three [p<0.01]. However, the speech and sphincteric disorders improved similarly in the three groups [p>0.05]. Evaluation of MCA hemodynamics status by TCD predicts the motor function improvement six months later in the patients with acute brain stroke