Document Type : Special Articles

Authors

• Massoud Mahmoudian ¹
• Mohammad Rezvani ²
• Mohammad Rohani ³
• Foozya Benaissa ³
• Mehdi Jalili ²
• Shadi Ghourchian ³

¹ Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

² Department of Neurology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

³ Department of Neurology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Background: Massive ischemic stroke causes significant mortality and morbidity in stroke patients. The main treatments for massive ischemic stroke are recombinant tissue plasminogen activator (rtPA), craniotomy, and endovascular interventions. Due to destructive  effects  of   bradykinin  on  the  nervous system in ischemic stroke, it seems reasonable that using Noscapine as a Bradykinin antagonist may improve patients’ outcome after ischemic stroke. The effect of Noscapine on massive ischemic stroke was shown by the previous pilot study by our group. This pseudo-randomized clinical trial study was designed to assess the result of the pilot study.Methods: Patients who had clinical symptoms or computed tomography scan indicative of massive stroke (in full middle cerebral artery territory) were entered to the study. The cases received the drugs according to their turns in emergency ward (pseudo-randomized). The patient group received Noscapine, and the control group received common supportive treatments. The patients and data analyzer were blinded about the data. At the mend of the study, to adjust confounding variables we used logistic regression.Results: After 1-month follow-up, 16 patients in the control group and 11 patients in the case group expired (P = 0.193). Analyzing the data extracted from Rankin scale and Barthel index check lists, revealed no significant differences in the two groups.Conclusion: Despite the absence of significant statistical results in our study, the reduction rate of 16% for mortality rate in Noscapine recipients is clinically remarkable and  motivates future  studies  with  larger sample sizes.