Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:

Saturday, October 22, 2016

Effect of soy on metabolic syndrome and cardiovascular risk factors: A randomized controlled trial

Yet, this will NEVER be translated into a diet protocol publicly available to all. We have complete incompetency in our fucking failures of stroke associations. I've only referenced that failure 242 times. How can the employees, presidents and boards of directors live with themselves?

European Journal of Nutrition, 10/19/2016

Ruscica M, et al. – Researchers conducted this study to determine the impact of soy on metabolic syndrome and cardiovascular risk factors. It was observed in the findings that the inclusion of whole soy foods in a lipid–lowering diet significantly enhanced a relevant set of biomarkers connected with cardiovascular risk.


  • The study was composed as a randomized, parallel, single-center study with a nutritional intervention duration of 12 weeks.
  • To pursue this research whole soy foods corresponding to 30 g/day soy protein were given in substitution of animal foods containing the same protein amount.


  • Researchers found that soy nutritional intervention resulted in a lessening in the number of MetS features in 13/26 subjects.
  • In addition, in the soy group they observed a significant improvement of median percentage changes for body weight (-1.5 %) and BMI (-1.5 %), and additionally for atherogenic lipid markers, namely TC (-4.85 %), LDL-C (-5.25 %), non-HDL-C (-7.14 %) and apoB (-14.8 %).
  • Since the majority of the studied variables were strongly correlated, 3 factors were identified which explained the majority (52 %) of the total variance in the whole data set.
  • Among them, factor 1, which loaded lipid and adipose variables, clarified the 22 % of aggregate variance, demonstrating a statistically significant difference between treatment arms (p = 0.002).

Go to PubMed Go to Abstract Print Article Summary Cat 2 CME Report

Percutaneous coronary intervention as a trigger for stroke

Be careful out there. What is your doctor doing to reduce that risk? Concrete steps being taken? Not just wait and hope.

The American Journal of Cardiology, 10/18/2016

This study suggests that first 2 days after percutaneous coronary intervention (PCI) is a vulnerable period for ischemic stroke development and the relative risk of stroke thereafter decreases gradually, but continues to remain elevated for 8 weeks.

Go to Abstract Print Article Summary Cat 2 CME Report

A post-stroke therapeutic regimen with omega-3 polyunsaturated fatty acids that promotes white matter integrity and beneficial microglial responses after cerebral ischemia

I bet your doctor will NEVER use this on you to help your recovery and prevent more disability. If this is not in your hospital in the next couple months you need to have the stroke department head and the president fired. We need to start demanding accountability in our stroke hospitals. The time for politeness is over, start screaming in their faces; 'Why the fuck do you know nothing  newer than your medical training days about stroke?'

Translational Stroke Research, 10/14/2016

Researchers, in this present study, report a post–stroke omega–3 polyunsaturated fatty acid (n–3 PUFA) therapeutic regimen that not only confers protection against neuronal loss in the gray matter but also promotes white matter integrity. As per the outcomes the post–stroke docosahexaenoic acid (DHA) injections in combination with fish oil (FO) dietary supplement benefit white matter restoration and microglial responses, thereby dictating long–term functional improvements.

Go to PubMed Go to Abstract Print Article Summary Cat 2 CME Report

Dietary glycemic index, glycemic load, and refined carbohydrates are associated with risk of stroke: A prospective cohort study in urban Chinese women

Yet, this will NEVER be translated into a diet protocol publicly available to all. We have complete incompetency in our fucking failures of stroke associations. I've only referenced that failure 241 times. How can the employees, presidents and boards of directors live with themselves? Cognitive dissonance whereby they have convinced themselves that press releases are doing some good? Talk to any survivor out there and see first hand that nothing you are doing helps them. Stroke groups do not count, they are just placation not solutions.

American Journal of Clinical Nutrition, 10/18/2016

For this study, researchers analyzed dietary glycemic index (GI), glycemic load (GL), and consumptions of refined and total carbohydrates in connection with risks of total, ischemic, and hemorrhagic stroke and stroke mortality. These outcomes recommend that high dietary GI and GL, primarily because of high consumptions of refined grains, are connected with expanded risks of total, ischemic, and hemorrhagic stroke in middle–aged and older urban Chinese women.

Go to PubMed Go to Abstract Print Article Summary Cat 2 CME Report

Review of clinical trials suggests eating oats can lower cholesterol levels as measured by a variety of markers

I bet your doctor will not use this to update your diet stroke protocol and allow you not to take statins. Do not do this on your own, that would be dangerous and stupid.

Toronto, October 11, 2016
By Leslie Shepherd

Researchers have known for more than 50 years that eating oats can potentially lower cholesterol levels and thus reduce a person’s risk of developing cardiovascular disease.
Studies during that time have focused on the impact of oats on levels of LDL (or “lousy”) cholesterol, which collects in the walls of blood vessels where it can cause blockages or blood clots.
But there is growing evidence that two other markers provide an even more accurate assessment of cardiovascular risk -- non-HDL cholesterol (total cholesterol minus the “H” or “healthy cholesterol”) and apolipoprotein B, or apoB, a lipoprotein that carries bad cholesterol through the blood. This is especially true for people with metabolic syndrome and Type 2 diabetes, since they typically do not have elevated LDL cholesterol levels.
A new systematic review and meta-analysis of randomized controlled trials has concluded that eating oat fibre can reduce all three markers. The study, led by Dr. Vladimir Vuksan, a research scientist and associate director of the Risk Factor Modification Centre of St. Michael’s Hospital, was published online in the British Journal of Nutrition.
Dr. Vuksan said oats are a rich source of beta-glucan, a viscous soluble fibre, which seems to be responsible for the beneficial effects. The first study of its kind, published in 1963, found that substituting white bread with oat bread containing 140g of rolled oats lowered LDL cholesterol.
Dr. Vuksan’s group looked at 58 clinical trials involving almost 4,000 people from around the world that assessed the effect of diets enriched with oat beta-glucan compared with controlled diets on LDL cholesterol, and, for the first time, on non-HDL cholesterol and apoB as well.
“Diets enriched with about 3.5 grams a day of beta-glucan fiber from oats were found to modestly improve LDL cholesterol, but also non-HDC and apoB compared to control diets,” Dr. Vuksan said.
The review found that overall, LDL cholesterol was reduced by 4.2 per cent, non-HDL cholesterol by 4.8 per cent and apoB by 2.3 per cent.
Dr. Vuksan said it could be difficult for people to consume the recommended amount of oat fiber by eating oat meal alone so he recommends people increase their consumption of oat bran. For example, one cup of cooked oat bran (88 calories) contains the same quantity of beta-glucan as double the amount of cooked oat meal (166 calories). Oat bran can also be eaten as a cereal, used in some baked goods (although since it is low in gluten, the texture may be tough) or sprinkled on other foods.
Canada is the third largest producer of oats in the world, so increasing consumption is good for health and the economy as well, Dr. Vuksan said. Consumption of oats has been declining considerably for many years.

This paper is an example of how St. Michael's Hospital is making Ontario Healthier, Wealthier, Smarter.

Mortality and cardiovascular disease: you don’t have to be an Olympic athlete to reduce the many risk factors

Being in great shape didn't prevent my stroke although it probably saved my life.
A new study, whose preliminary results will be presented today at the Canadian Cardiovascular Congress and soon be published in the Journal of Cardiopulmonary Rehabilitation and Prevention, shows that even low physical fitness, up to 20% below the average for healthy people, is sufficient to produce a preventive effect on most of the risk factors that affect people with cardiovascular disease.

Researchers, it is hoped, will one day find a miracle cure for all kinds of diseases. Yet over and over again it has been shown that even if it takes a little more effort than swallowing a little pill, exercise is an excellent preventive and curative treatment for many diseases. A new study, whose preliminary results will be presented today at the Canadian Cardiovascular Congress and soon be published in the Journal of Cardiopulmonary Rehabilitation and Prevention, also supports this finding. The study shows that even low physical fitness, up to 20% below the average for healthy people, is sufficient to produce a preventive effect on most of the risk factors that affect people with cardiovascular disease.

"This is great news for people with heart disease who have difficulty adhering to a regular—mainly aerobic—exercise program," said Daniel Curnier, a professor at the University of Montreal’s Department of Kinesiology, who led the study. "Small improvements in their fitness level are enough. You don’t have to be an great athlete to benefit from these effects.”

"We know from many studies that good physical fitness reduces cardiovascular mortality, and that physical activity has a positive impact on cardiovascular risk factors following a rehab program," said Maxime Caru, a doctoral student in human kinetics at UdeM and lead author of the study. “However, the impact of physical fitness level on risk factors has remained an open question. That is why our research team asked the following question: “Is good physical condition required to produce a preventive effect on these cardiovascular risk factors?”

Pedalling with heart

Changes in society, marked by industrialization, have had a significant impact on the physical activity of humans, who have become increasingly sedentary over the years. The increase in risk factors, including abdominal circumference, depression, diabetes, dyslipidemia, hypertension, obesity, excess weight, and smoking—along with physical inactivity—provides the perfect storm for developing heart disease, which is one of the leading causes of death in the world, representing 31% of global mortality. And it has continued to grow in recent years.

“It is common to meet people entering a cardiac rehab centre who are totally out of shape and whose exercise is irregular or non-existent,  which has a harmful effect on general and cardiovascular health," said Caru, who is also a doctoral student in psychology at the University of Paris-Nanterre. To measure the impact of physical fitness on heart disease risk factors, the researchers selected 205 men and 44 women with heart disease, including coronary artery disease, stroke, congestive heart failure, and heart valve disease, and had them undergo a cycle ergometer (stationary bike) stress test to determine their fitness level. The results showed that normal physical fitness, even up to 20% below the population average, is sufficient to have a preventive effect on five of the eight risk factors affecting people with cardiovascular disease—abdominal circumference, diabetes, hypertension, obesity, and excess weight. Normal physical fitness means having the physical fitness of a person of the same weight, height, sex, and age, and who is disease-free. The easiest way to achieve this is to follow the recommendations of the World Health Organization—150 minutes per week of moderate exercise or 75 minutes of vigorous exercise.

Depression: higher standards

Depression is a significant risk factor for cardiovascular disease because cardiac patients who have experienced a depressive episode have recurring heart problems. The results of the study have demonstrated the importance of a good fitness level, before and after a heart attack, to produce the preventive effect on depression.

The study sheds new light on the overall role of physical fitness in the development of cardiovascular risk factors in patients with cardiovascular disease. However, the researchers stress the importance for cardiac patients to consult their doctor before embarking on an exercise program and to consult a kinesiologist: “Only these professionals are able to know which type of exercise is safe for your condition and how to implement an exercise program,” warn the authors.

About the study

Maxime Caru and Daniel Curnier presented Preventive fraction of physical fitness on risk factors in cardiac patients at the Canadian Cardiovascular Congress on October 21, 2016. The scientific article, signed by Maxime Caru, Laurence Kern, Marc Bousquet, and Daniel Curnier will soon be published in the Journal of Cardiopulmonary Rehabilitation and Prevention.

Friday, October 21, 2016

Betrayal of stroke patients: Sufferers are forced to wait months for NHS rehab

The real betrayal is that your doctors are doing NOTHING during the first week to stop the neuronal cascade of death by these 5 causes. Rehab is a total failure since only 10% of stroke survivors fully recover and zero percent of that is from your doctors intervention. Solve the correct problem.

Betrayal of stroke patients: Sufferers are forced to wait months for NHS rehab 

Stroke victims are having to wait more than four months for physiotherapy after leaving hospital, according to a report.
The delays have a ‘devastating’ impact on patients’ recovery and undo previous painstaking hard work, experts say.
Around 152,000 UK adults suffer a stroke each year and some are left paralysed on one side of the body or very weak in their limbs.

They have to relearn basic movements through physiotherapy sessions involving repetitive exercises.
Research by the Chartered Society of Physiotherapy found 85 per cent of health trusts do not offer stroke victims physiotherapy within two weeks of leaving hospital. A fifth make them wait at least 13 weeks and 4 per cent cannot offer sessions until after 18 weeks.
The society’s Catherine Pope said: ‘The results of this audit are a stark reminder that too many patients are being let down once they leave hospital.

Dominic Brand, of the Stroke Association, has called the NHS figures 'extremely concerning'
The research involved Freedom of Information requests to all 209 clinical commissioning groups in England, of which 135 replied.
Dominic Brand, a spokesman for the Stroke Association, described the findings as ‘extremely concerning’.
‘Major strides have been made in the way stroke is treated in hospital; however, it is clear that far too many stroke survivors are going without the right support,’ he said.
‘Stroke survivors regularly tell us they have had to wait weeks – and in some cases months – for the support and therapy they need to rebuild their lives.
‘For too many people, their support comes too late, it stops too soon, or they don’t have access to all types of therapy they need.’

Unless someone like you cares a whole awful lot, nothing is going to get better. It's not. The Lorax

Obviously our fucking failures of stroke associations (ASA, NSA, WSO) don't care about stroke at all. Nothing in stroke is getting better.

Dementia risk after spontaneous intracerebral haemorrhage: a prospective cohort study

I don't think anyone knows the risk of dementia post stroke other than it occurs. What the fuck is your doctor doing to prevent that dementia?  Maybe my ideas here?

Dementia prevention 19 ways

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.
3. A 20% chance in this research. 
  July 2013.

The latest study here:

Dementia risk after spontaneous intracerebral haemorrhage: a prospective cohort study



Dementia occurs in at least 10% of patients within 1 year after stroke.(reference?) However, the risk of dementia after spontaneous intracerebral haemorrhage that accounts for about 15% of all strokes has not been investigated in prospective studies. We aimed to determine the incidence of dementia and risk factors after an intracerebral haemorrhage.


We did a prospective observational cohort study in patients with spontaneous intracerebral haemorrhage from the Prognosis of Intracerebral Haemorrhage (PITCH) cohort who were admitted to Lille University Hospital, Lille, France. We included patients aged 18 years and older with parenchymal haemorrhage on the first CT scan. Exclusion criteria were pure intraventricular haemorrhage; intracerebral haemorrhage resulting from intracranial vascular malformation, intracranial venous thrombosis, head trauma, or tumour; haemorrhagic transformation within an infarct; and referral from other hospitals. Median follow-up was 6 years. We studied risk factors (clinical and neuroradiological [MRI] biomarkers) of new-onset dementia as per a prespecified subgroup analysis, according to intracerebral haemorrhage location. Dementia diagnosis was based on the National Institute on Aging-Alzheimer's Association criteria for all-cause dementia. We did multivariable analyses using competing risk analyses, with death during follow-up as a competing event.


From the 560 patients with spontaneous intracerebral haemorrhage enrolled in the PITCH cohort between Nov 3, 2004 and March 29, 2009, we included 218 patients (median age 67·5 years) without pre-existing dementia who were alive at 6 months follow-up. 63 patients developed new-onset dementia leading to an incidence rate of 14·2% (95% CI 10·0-19·3) at 1 year after intracerebral haemorrhage, and incidence reached 28·3% (22·4-34·5) at 4 years. The incidence of new-onset dementia was more than two times higher in patients with lobar intracerebral haemorrhage (incidence at 1 year 23·4%, 14·6-33·3) than for patients with non-lobar intracerebral haemorrhage (incidence at 1 year 9·2%, 5·1-14·7). Disseminated superficial siderosis (subhazard ratio [SHR] 7·45, 95% CI 4·27-12·99), cortical atrophy score (SHR per 1-point increase 2·61, 1·70-4·01), a higher number of cerebral microbleeds (SHR for >5 cerebral microbleeds 2·33, 1·38-3·94), and older age (SHR per 10-year increase 1·34, 1·00-1·79) were risk factors of new-onset dementia.
Totally not understandable for laypersons.


There is a substantial risk of incident dementia in dementia-free survivors of spontaneous intracerebral haemorrhage; our results suggest that underlying cerebral amyloid angiopathy is a contributing factor to the occurrence of new-onset dementia. Future clinical trials including patients with intracerebral haemorrhage should assess cognitive endpoints.


French Ministry of Education, Research, and Technology, Adrinord, Inserm U1171.

NSF grant supports new approach to gait training for stroke survivors

There are lots of walking assist devices out there, I have described dozens. Your doctor should know of them and be testing them for the best ones to be implemented in their hospital. But I can guarantee that is not occurring. Your stroke  hospital is a fucking failure, they aren't doing one damn thing about new research and applying it to help survivors.
Thirty percent of stroke survivors, including some 300,000 Americans every year, are left with compromised walking ability. As our population ages, these numbers will undoubtedly grow, increasing the already high demand for technology to support gait training.
“For most stroke survivors who are left with mobility impairments, recovering the ability to walk is at or near the top of their wish list for rehabilitation,” says Darcy Reisman, associate professor of physical therapy at the University of Delaware. “It’s also critical to their being able to live at home again after a stroke.”
Wearable robots, which use electrically actuated motors to control joint motion, are ideal candidates to automate gait training. However, while great advances have been made in sensing, actuation, and computation, the potential of wearable robots in gait neuro-rehabilitation has not yet been fully realized.
Fabrizio Sergi, assistant professor of biomedical engineering at UD, says there are challenges in designing assistive forces for wearable robots that are capable of teaching stable and energetically efficient walking patterns while also accommodating variability from one individual to another.
To address these challenges, Sergi is partnering with Reisman and Jill Higginson, associate professor of mechanical and biomedical engineering at UD. The team was recently awarded a three-year grant from the National Science Foundation’s National Robotics Initiative to develop an approach called GOALL (Goal-Oriented, subject Adaptive, robot-assisted Locomotor Learning).
GOALL combines biomechanical modeling with experiments using a lower-extremity exoskeleton to determine the robotic assistance forces needed to induce changes in gait parameters like step length and walking speed.
“We are currently pursuing a new approach to robotic gait training based on pulses of assistive forces,” says Sergi. “In this project, we will determine when to apply pulses, how large those pulses should be, and to which joints they should be applied.”
Higginson adds, “The robot will have the unique ability to adapt to a patient’s needs as his or her walking improves, just as a therapist would do.”
The interdisciplinary project combines Sergi’s expertise in robotic systems design and control with Higginson’s knowledge on the use of computational models to relate muscle impairments to gait deviations, as well as Reisman’s clinical perspective on post-stroke rehabilitation. The research methods used and the results obtained from the project will benefit both the robotics and biomechanics communities.

34-Year-Old Model Katie May Died From A Stroke—Here’s What You Should Know

This coroner needs to be trained in brain anatomy. Only if the Circle of Willis was incomplete would the event as described directly cause a stroke. So the coroner did not do enough investigation to find the assisting causes.

According to information from the Los Angeles County Coroner released today, the stroke that killed 34-year-old model Katie May in February was caused by "an injury sustained during a 'neck manipulation by chiropractor,'" People reports. The coroner's assessment is that when May visited a chiropractor for an adjustment in her neck, it caused a tear in her left vertebral artery. "The tear blocked blood flow to May’s brain and caused the stroke," People reports. It was previously believed that a block in her carotid artery following a fall during a photoshoot may have been the cause of the fatal stroke.
Originally published on Feb. 5, 2016:In tragic news this week, 34-year-old model and single mom Katie May has died. In a statement to People, May's family confirmed that her untimely death was caused by a stroke. May, who modeled for Playboy and Sports Illustrated, was a social media star with over 1.7 million Instagram followers and countless fans."It is with heavy hearts that we confirm the passing today of Katie May—mother, daughter, sister, friend, businesswoman, model and social media star—after suffering a catastrophic stroke caused by a blocked carotid artery on Monday," the statement said. "Known as MsKatieMay on the Internet and the 'Queen of Snapchat,' she leaves behind millions of fans and followers, and a heartbroken family. We respectfully ask for privacy in this this difficult time."In addition to being incredibly sad, her death is also understandably alarming, given that May was only 34. Her family told the New York Daily News that the model had been complaining of neck pain and was seeking treatment. Fox News reports that May took a nasty fall during a photoshoot last week, causing what the model believed to be a pinched nerve. This injury may actually have been a tear in her carotid artery. One theory is that this tear caused a blockage in the artery, triggering a "catastrophic" stroke by stopping blood flow to her brain and depriving it of oxygen. May leaves behind a beloved 7-year-old daughter, Mia.May’s untimely death is an unfortunate reminder of how strokes can affect young women, more than you might realize.Here are five facts every young woman should know about stroke.

1. Young people can get strokes, too.

The American Stroke Association wants you to know that strokes don't only happen to "elderly overweight smokers who have high blood pressure or high cholesterol." In fact, 35 percent of strokes happen to people under 65, and a full 10 percent of strokes happen to people under the age of 45, like May. And when young people go to the ER with stroke symptoms they won't be correctly diagnosed.

Pediatric Stroke Often Misdiagnosed, Treatment Delayed


2. More women die from strokes than breast cancer.

According to the CDC, one in five U.S. women will have a stroke, and a lot of people don't know about the risks. In fact, stroke kills twice as many women as breast cancer does every year. While this stat sounds troubling, staying informed can go a long way to keeping yourself healthy.

3. Certain things can increase your risk of stroke, and you should be aware of them.

There are several "hidden" factors affecting women specifically. You might be more prone to having a stroke if you have migraines with aura (aka weird vision squiggles or black spots), an autoimmune disease or a clotting disorder, or if you are taking Hormone Replacement Therapy (HRT). Another concern is birth control pills. Some estrogen-based contraceptives put women at a higher risk for getting a blood clot, and blood clots can cause a stroke. (It's worth noting that the increased risk with birth control is also impacted by your age, family history, whether you smoke, if you get those migraines with aura mentioned earlier, and other factors; talk to your doctor if you have questions or concerns about your birth control). Finally, being pregnant can make you more susceptible to a stroke. If you experience any of these things, you should definitely talk to your physician about your stroke risk and how to identify symptoms, as well as how to lower your risk.Oh, one more thing: It's possible that a nasty fall could be linked to a higher risk of stroke. While the exact details of what caused May's death are unknown, some outlets have linked her stroke to a reported fall at a recent photoshoot. Studies have suggested that head injuries can lead to strokes, and that people with a traumatic brain injury (TBI) have an increased risk. If you're still in pain after a fall, don't ignore your symptoms.

4. All that being said, there are definitely things you can do to lower your risk.

Some of the risk depends on your age and family history, of course, but not all of it is outside your control. For instance, smoking is one of the biggest risk factors, so quitting will definitely help. If you have high blood pressure, work with your doctor to do what you can to keep it under control. If you experience migraines with aura, you should definitely talk to your doctor about what birth control might be best for you. And if you are planning to have a baby, talk with your physician about how to monitor your blood pressure.
Like a 307%  stroke risk reduction from these 11 possibilities? 

5. It’s super important that if you suspect you’re having a stroke, you get treatment quickly.

And yet there is only a 12% full recovery rate from using tPA


Time is of the essence, because strokes cause brain cell death. Doctors believe that getting medical treatment within one to three hours of the stroke occurring can make a huge difference when it comes to chances for recovery.Be on the lookout for signs that you are having a stroke, like a sudden weakness in the face or limbs (especially on one side of the body), sudden severe headache, trouble speaking, trouble seeing out of one or both eyes, and sudden difficulty walking. And, just as women have unique risk factors, they can experience unique symptoms, too, like fainting, shortness of breath, agitation, sudden behavioral change, hallucination, nausea, pain, seizures, confusion, or disorientation. If you're experiencing any combination of these things, call 911 or head to an ER right away.


Relearn Faster and Retain Longer Along With Practice, Sleep Makes Perfect

I bet your doctor won't take this to heart and change your stroke protocols to have sleep sessions in between therapy sessions. I bet your doctor doesn't even know about this research and will never know about this research.
  1. Stéphanie Mazza1
  2. Emilie Gerbier2
  3. Marie-Paule Gustin3,4
  4. Zumrut Kasikci1
  5. Olivier Koenig1
  6. Thomas C. Toppino5
  7. Michel Magnin6
  1. 1Laboratoire d’Étude des Mécanismes Cognitifs, Équipe d’Accueil 3082, Université Lyon 2, Université de Lyon
  2. 2Bases, Corpus, Langage Lab, Department of Psychology, Unité Mixte de Recherche (UMR) 7320, Centre National de la Recherche Scientifique (CNRS), Université Nice Sophia Antipolis
  3. 3Department of Public Health, Institut des Sciences Pharmaceutiques et Biologiques, Équipe d’Accueil 4173, Université de Lyon
  4. 4Emerging Pathogens Laboratory – Fondation Mérieux, International Center for Infectious Diseases Research (CIRI), Institut National de la Santé et de la Recherche Médicale (INSERM) U111, UMR 5308, École Normale Supérieure de Lyon, Université Claude Bernard Lyon 1
  5. 5Department of Psychology, Villanova University
  6. 6Central Integration of Pain (NeuroPain) Lab—Lyon Neuroscience Research Center, INSERM U1028, UMR 5292, CNRS, Université Claude Bernard Lyon 1
  1. Stephanie Mazza, Laboratoire d’Étude des Mécanismes Cognitifs, EA 3082, Université Lyon 2, Lyon, France E-mail:
  1. Author Contributions S. Mazza, E. Gerbier, and O. Koenig designed the experiments. S. Mazza and Z. Kasikci performed all experiments. S. Mazza, E. Gerbier, M.-P. Gustin, and M. Magnin performed the analyses. S. Mazza, E. Gerbier, T. C. Toppino, and M. Magnin wrote the manuscript after discussion among all the authors. S. Mazza and M. Magnin supervised and coordinated the project.


Both repeated practice and sleep improve long-term retention of information. The assumed common mechanism underlying these effects is memory reactivation, either on-line and effortful or off-line and effortless. In the study reported here, we investigated whether sleep-dependent memory consolidation could help to save practice time during relearning. During two sessions occurring 12 hr apart, 40 participants practiced foreign vocabulary until they reached a perfect level of performance. Half of them learned in the morning and relearned in the evening of a single day. The other half learned in the evening of one day, slept, and then relearned in the morning of the next day. Their retention was assessed 1 week later and 6 months later. We found that interleaving sleep between learning sessions not only reduced the amount of practice needed by half but also ensured much better long-term retention. Sleeping after learning is definitely a good strategy, but sleeping between two learning sessions is a better strategy.

Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study

By focusing on blaming the patient these researchers are giving the ok to not even try to solve ANY of the fucking problems in stroke. 'You caused your own stroke, live with the consequences', not a direct quote but implied.
Prof Denis Xavier, MD
Prof Lisheng Liu, MD
Prof Hongye Zhang, MD
Prof Prem Pais, MD
Prof Matthew J McQueen, MBChB
Prof Graeme J Hankey, FRACP
Prof Antonio L Dans, MD
Prof Khalid Yusoff, FRCP
Prof Ralph L Sacco, MD
Prof Xingyu Wang, PhD
Prof Salim Yusuf, DPhil
, on behalf of the INTERSTROKE investigators
Members listed at end of paper
This article can be found in the following collections: Cerebrovascular disease



The contribution of various risk factors to the burden of stroke worldwide is unknown, particularly in countries of low and middle income. We aimed to establish the association of known and emerging risk factors with stroke and its primary subtypes, assess the contribution of these risk factors to the burden of stroke, and explore the differences between risk factors for stroke and myocardial infarction.


We undertook a standardised case-control study in 22 countries worldwide between March 1, 2007, and April 23, 2010. Cases were patients with acute first stroke (within 5 days of symptoms onset and 72 h of hospital admission). Controls had no history of stroke, and were matched with cases for age and sex. All participants completed a structured questionnaire and a physical examination, and most provided blood and urine samples. We calculated odds ratios (ORs) and population-attributable risks (PARs) for the association of all stroke, ischaemic stroke, and intracerebral haemorrhagic stroke with selected risk factors.


In the first 3000 cases (n=2337, 78%, with ischaemic stroke; n=663, 22%, with intracerebral haemorrhagic stroke) and 3000 controls, significant risk factors for all stroke were: history of hypertension (OR 2·64, 99% CI 2·26–3·08; PAR 34·6%, 99% CI 30·4–39·1); current smoking (2·09, 1·75–2·51; 18·9%, 15·3–23·1); waist-to-hip ratio (1·65, 1·36–1·99 for highest vs lowest tertile; 26·5%, 18·8–36·0); diet risk score (1·35, 1·11–1·64 for highest vs lowest tertile; 18·8%, 11·2–29·7); regular physical activity (0·69, 0·53–0·90; 28·5%, 14·5–48·5); diabetes mellitus (1·36, 1·10–1·68; 5·0%, 2·6–9·5); alcohol intake (1·51, 1·18–1·92 for more than 30 drinks per month or binge drinking; 3·8%, 0·9–14·4); psychosocial stress (1·30, 1·06–1·60; 4·6%, 2·1–9·6) and depression (1·35, 1·10–1·66; 5·2%, 2·7–9·8); cardiac causes (2·38, 1·77–3·20; 6·7%, 4·8–9·1); and ratio of apolipoproteins B to A1 (1·89, 1·49–2·40 for highest vs lowest tertile; 24·9%, 15·7–37·1). Collectively, these risk factors accounted for 88·1% (99% CI 82·3–92·2) of the PAR for all stroke. When an alternate definition of hypertension was used (history of hypertension or blood pressure >160/90 mm Hg), the combined PAR was 90·3% (85·3–93·7) for all stroke. These risk factors were all significant for ischaemic stroke, whereas hypertension, smoking, waist-to-hip ratio, diet, and alcohol intake were significant risk factors for intracerebral haemorrhagic stroke.


Our findings suggest that ten risk factors are associated with 90% of the risk of stroke. Targeted interventions that reduce blood pressure and smoking, and promote physical activity and a healthy diet, could substantially reduce the burden of stroke.


Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, Canadian Stroke Network, Pfizer Cardiovascular Award, Merck, AstraZeneca, and Boehringer Ingelheim.

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Wednesday, October 19, 2016

Cryptogenic stroke

Unknown origin of the stroke. As a computer programmer my manager never let me get away with saying the problem could not be explained or solved. If I continued to make excuses I would have been fired.  Your neurologist should never be let off the hook and not explain the origin of the stroke. I don't care how fucking long it takes, I have spent 3-6 months at a time solving some of my most difficult challenges.

Hospital saw three adult ADHD patients with ischemic stroke in one week

UCLA-led study shows treatment can provide benefits up to 7.3 hours after onset of stroke

Yet your doctors are doing fucking nothing in the first week to stop the neuronal cascade of death by these 5 causes. 

Time is of the essence when getting people stricken with acute ischemic strokes to treatment. And the use of stent retrievers — devices that remove the blood clot like pulling a cork out of a wine bottle — has proven to be a breakthrough for removing the life-threatening blockage of blood flow to the brain.
Current professional guidelines recommend that the procedure be performed within six hours for people to benefit. But researchers on a UCLA-led study published today in the Journal of the American Medical Association have found that the procedure has benefits for people up to 7.3 hours following the onset of a stroke.
"Extending the time window for therapy will let us help more patients, including patients who were not able to get to a hospital right away because the stroke started while they were asleep or made them unable to call for help," said Dr. Jeffrey Saver, director of the UCLA Comprehensive Stroke Center and the study's lead author.
The researchers also found that for each six-minute delay, there is a 1 percent increase in the proportion of people who end up disabled, underscoring the need for people to seek treatment as quickly as possible when they experience symptoms of a stroke. The study examined the relationship between the onset of the stroke, the amount of time until the blockage was treated and patient outcomes.
The first coil-shaped clot retriever was invented at UCLA and cleared for use in 2004. For this study, researchers primarily used a newer generation of stent retrievers, which were cleared for use in 2012. First, doctors insert the small mesh tubes through an artery in the leg to the blockage in the artery that takes blood to the brain. Next, they open the mesh tubes in the middle of the clot and then extract the stent and the clot to restore blood flow to the brain.
The current study combines data from five clinical trials involving a total of 1,287 people, including the SWIFT PRIME trial led by Saver, that show these devices improved outcomes for people with acute ischemic strokes due to large vessel blockage. The researchers analyzed the relationship between time from onset of the blockage to treatment and outcome among these patients.
The researchers found that people treated earlier with the retrievers plus standard medical therapy were less likely to be disabled three months after surgery than people who only received medical therapy. Outcomes were the best if the procedure was done within the first two hours of a stroke, but those treated up to 7.3 hours after a stroke continued to show a lesser benefit.
Earlier treatment is better than later treatment to restore blood flow and prevent or limit damage to the brain, Saver noted.
"It is important for the public to know the critically important relationship between time to treatment and outcome, so they know to activate the 911 system as soon as possible when they detect stroke symptoms in themselves or friends, family and co-workers," he said. "And it is important to reorganize regional systems of stroke care to ensure that ambulances transport appropriate patients to hospitals that perform this procedure quickly and safely."
The people in these trials were seen at mostly academic medical centers, so the question remains as to whether these same results can be achieved at non-academically affiliated medical centers. Other elements that could skew the results include differences in trial entry criteria and patient characteristics, and that these results may not apply to people who did not qualify for the trials.
In future studies, the researchers plan to use brain imaging techniques to determine if it is possible to identify a specific, smaller group of people who can benefit from the clot retrieval therapy seven to 24 hours after stroke onset, said Dr. Reza Jahan, professor of radiology and neurosurgery at UCLA, and a co-author of the study.
University of California, Los Angeles (UCLA), Health Sciences