Management of Completed Strokes With Dextran 40. A Community Hospital Failure

Fifty-nine patients with onset of moderate to severe unimproving paralysis of less than 24 hours' duration were randomized into treatment (Dextran 40) and control groups, managed similarly except for the dextran. A strict effort to study a uniform cerebral process by rejecting patients with hypertension, insulin-dependent diabetes, potential emboli, and pulmonary or renal disease resulted in a small sample. Most patients considered for the study had begun to improve before the initial examination. All patients had spinal tap prior to the decision to randomize. Results were evaluated independently by the three authors over a three-week interval and tabulated after three years. A greater percentage of dextran-treated patients improved with respect to consciousness and strength in upper and lower extremities, but showed less restoration of language than the untreated patients. The differences in the two groups were not significant. One of 30 patients given dextran may have had a reaction.