This Article Full Text Full Text (PDF) All Versions of this Article: 39/2/512    most recent STROKEAHA.107.496778v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bereczki, D. Articles by Fekete, I. Search for Related Content PubMed PubMed Citation Articles by Bereczki, D. Articles by Fekete, I. Related Collections Acute Cerebral Hemorrhage Acute Cerebral Infarction Other Stroke Treatment - Medical

(Stroke. 2008;39:512.)
© 2008 American Heart Association, Inc.

Cochrane Corner

Mannitol for Acute Stroke

Dániel Bereczki, MD, PhD, DSc; Ming Liu, MD; Gilmar Fernandes do Prado, MD, PhD István Fekete, MD, PhD

From the Department of Neurology (D.B.), Semmelweis University, Budapest, Hungary; the Department of Neurology (D.B., I.F.), Health Science and Medical Center, University of Debrecen, Hungary; the Department of Neurology (M.L.), West China Hospital, Sichuan University, China; and the Department of Internal Medicine (G.F.d.P.), Federal University of Sao Paulo, Brazil.

Correspondence to Dr Daniel Bereczki, Department of Neurology, Semmelweis University, Balassa U. 6, Budapest, Hungary, H-1083. E-mail bereczki@neur.sote.hu

Graeme J. Hankey MD, FRCP Section Editor:

Key Words: acute stroke • edema, brain • systematic review • treatment

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Mannitol is an osmotic agent and a free radical scavenger and thus might decrease edema and tissue damage in stroke, and has been given a Class 2a recommendation (ie, probably indicated to decrease brain edema after large cerebral infarctions) for use in acute stroke in recent guidelines.¹

	Objectives

 
To test whether treatment with mannitol reduces short and long-term case fatality and dependency after acute ischemic stroke or intracerebral hemorrhage (ICH).

	Search Strategy

 
We searched the Cochrane Stroke Group Trials Register, the Chinese Stroke Trials Register, the China Biological Medicine Database, MEDLINE (1966 to 2006), and the Latin-American database LILACS (1982 to December 2006). In addition we searched the database of Masters and PhD degree theses at Sao Paulo University and abstracts of medical congresses on neurology and neurosurgery from 1965 to 2006 in Brazil. We searched reference lists and contacted authors of published trials. Last searches were performed between September 2006 and February 2007.

	Selection Criteria

 
Truly randomized unconfounded clinical trials comparing the effect of mannitol with placebo or open control in patients with acute ischemic stroke or nontraumatic intracerebral hemorrhage were eligible for inclusion.

	Data Collection and Analysis

 
Two reviewers independently selected the trials for inclusion, extracted, and analyzed the data. Included trials were tabulated for methodological quality. Data synthesis and analysis was performed using RevMan version 4.3.1.

	Main Results

 
Three trials fulfilled the inclusion criteria. The number of included patients was small (21, 77, and 128 patients). One trial with 77 subjects randomized patients with presumed ischemic stroke without CT verification, and the other 2 trials included patients with . . . [Full Text of this Article]

This article has been cited by other articles:

				E.S. Prakash Is the Use of Hypertonic Mannitol Appropriate in the Management of Intracerebral Hemorrhage? Stroke, May 1, 2008; 39(5): e85 - e85. [Full Text] [PDF]

				D. Bereczki, M. Liu, G. F. do Prado, and I. Fekete Response to Letter by Prakash Stroke, May 1, 2008; 39(5): e86 - e87. [Full Text] [PDF]