title: Cerebrolysin effects on neurological outcomes and cerebral blood flow in acute ischemic stroke.
abstract: BACKGROUND
  Cerebrolysin, a brain-derived neuropeptide, has been shown to improve the neurological outcomes of stroke, but no study has demonstrated its effect on cerebral blood flow. This study aimed to determine the cerebrolysin impact on the neurological outcomes and cerebral blood flow.
  
  
  METHODS
  In a randomized, double-blinded, placebo-controlled trial, 46 patients who had acute focal ischemic stroke were randomly assigned into two groups to receive intravenously either 30 mL of cerebrolysin diluted in normal saline daily for 10 days (n=23) or normal saline alone (n=23) adjunct to 100 mg of aspirin daily. All patients were examined using the National Institutes of Health Stroke Scale and transcranial Doppler to measure the mean flow velocity and pulsatility index (PI) of their cerebral arteries at baseline as well as on days 30, 60, and 90.
  
  
  RESULTS
  The patients' mean age was 60±9.7 years, and 51.2% of patients were male. The National Institutes of Health Stroke Scale was significantly lower in the cerebrolysin group compared with the placebo group on day 60 (median 10, interquartile range 9-11, P=0.008) and day 90 (median 11, interquartile range 10-13.5, P=0.001). The median of PI in the right middle cerebral artery was significantly lower in the cerebrolysin group compared with the placebo group on days 30, 60, and 90 (P<0.05). One patient in the cerebrolysin group and two patients in the placebo group died before day 30 (4.3% versus 8.7%).
  
  
  CONCLUSIONS
  Cerebrolysin can be useful to improve the neurological outcomes and the PI of middle cerebral artery in patients with acute focal ischemic stroke.
authors.affiliation: Department of Neurology, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Amiri-Nikpour
authors.affiliation: Department of Neurology, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Surena
authors.initials: S
authors.lastname: Nazarbaghi
authors.affiliation: Department of Neurology, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Babak
authors.initials: B
authors.lastname: Ahmadi-Salmasi
authors.affiliation: School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Tayebeh
authors.initials: T
authors.lastname: Mokari
authors.affiliation: School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Urya
authors.initials: U
authors.lastname: Tahamtan
authors.affiliation: Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Yousef
authors.initials: Y
authors.lastname: Rezaei
keywords: NIHSS; cerebrolysin; ischemic stroke; mean flow velocity; neuroprotection; pulsatility index