[Intravenous dipyridamole in acute cerebral infarct. Is it efficacious?]

To evaluate the efficiency of intravenous dipyridamole in the evolution of patients with acute ischemic stroke.

A double-blind clinical trial was conducted with 60 patients having a 24-h evolution of acute vascular stroke at the Hospital General No. 1 IMSS in the city of Colima, Mexico. After diagnosis, the patients were randomly assigned to two study groups. 10 mg of dipyridamole were administered intravenously every 8 h to the patients in one group, and 300 mg of aspirin were administered orally every 24 h to patients in the other. The patients in both groups received 25 to 50 ml/ kg of saline solution over a 24-h period. Basal conditions were registered using five parameters (food intake, walking, eye opening, motor activity and verbal responsiveness) during the first 5 days of evolution.

Six patients died, four from the group treated with dipyridamole and two treated with aspirin. There was no significant difference between the groups in reference to age (66 +/- 11 years) or sex, nor was there a difference in the severity of stroke between the groups. When the values of the parameters recorded for both groups were compared before and after treatment, the group receiving dipyridamole showed no significant change (p < 2), while the group receiving aspirin showed an improvement in three of the parameters (food intake, walking and motor activity (p < 0.003).

Our results indicate that dipyridamole does not modify basal conditions in patients suffering from acute ischemic stroke, while aspirin mildly favors improvement in these patients. We conclude that appropriate medical care, in the absence of complications, is the underlying condition permitting a satisfactory evolution in patients afflicted with brain vascular disease.