Biochemical and inflammatory biomarkers in ischemic stroke: translational study between humans and two experimental rat models.

Background: our objective was to examine the plasma levels of three biological markers involved in cerebral ischemia (IL-6, glutamate and TNF-alpha) in stroke patients and compare them with two different rat models of focal ischemia (embolic stroke model- ES and permanent middle cerebral artery occlusion ligation model-pMCAO) to evaluate which model is most similar to humans.

Secondary Objectives: 1) to analyze the relationship of these biological markers with the severity, volume and outcome of the brain infarction in humans and the two stroke models; and 2) to study whether the three biomarkers are also increased in response to damage in organs other than the central nervous system, both in humans and in rats.

Methods: Multi-center, prospective, case-control study including acute stroke patients (n=58) and controls (n=19) with acute non-neurological diseases

Main Variables: plasma biomarker levels on admission and at 72 h; stroke severity (NIHSS scale) and clinical severity (APACHE II scale); stroke volume; functional status at 3 months (modified Rankin Scale [mRS] and Barthel index [BI]).

[Decompressive craniectomy in malignant middle cerebral artery infarction. Experience after the implementation of a response protocol].

Introduction: Descompressive craniectomy (DC) for treatment of malignant infarction of the middle cerebral artery (MIMCA) reduces mortality and increases the probability of favourable outcome.

Aim: To present the experience in daily practice after implantation of a clinical protocol of DC.

Patients And Methods: Prospective register of patients with MIMCA treated with DC.

Relevance of stroke code, stroke unit and stroke networks in organization of acute stroke care--the Madrid acute stroke care program.

Stroke is a neurological emergency. The early administration of specific treatment improves the prognosis of the patients. Emergency care systems with early warning for the hospital regarding patients who are candidates for this treatment (stroke code) increases the number of patients treated.