Deans' stroke musings: The Science of Stroke: Mechanisms in Search of Treatments Dr. Michael A. Moskowitz

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 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:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. 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 lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, March 7, 2011

The Science of Stroke: Mechanisms in Search of Treatments Dr. Michael A. Moskowitz

When I first saw this referred to in ten steps forward in stroke research I knew I had to find it. I was unable to locate a free copy on the web so I contacted my local library and the librarian agreed to find me a copy from a partner library, but she ended up finding a free copy on the web here;
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WSS-515T9P7-K&_user=10&_coverDate=10%2F06%2F2010&_rdoc=17&_fmt=high&_orig=browse&_origin=browse&_zone=rslt_list_item&_srch=doc-info(%23toc%237054%232010%23999319998%232473768%23FLA%23display%23Volume)&_cdi=7054&_sort=d&_docanchor=&_ct=17&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=047db96ee281eb77b3593523a96758d8&searchtype=a
This is just the introduction, check out the URL if you want to read more;

Introduction

Few neurological conditions are as complex and devastating as

stroke, the second leading cause of death worldwide. Also

called a brain attack, victims may suddenly experience paralysis,

impaired speech, or loss of vision due to interruption of blood

flow (ischemia) caused by thrombosis or embolism. Less

frequently (<15%), strokes are caused by hemorrhage or cardiac

arrest. On average, strokes in the USA strike once every 40 s and

cause death every 4 min, with an estimated 41.6% death rate in

2007 (

absolute numbers are likely to rise. Among survivors, work

capacity is compromised in 70% of victims, and 30% need

assistance with self-care. Hence, the disease burden is great.

The estimated cost for stroke is 73.7 billion dollars in 2010

(USA) and projected to be 1.52 trillion dollars in 2050 (in 2005

dollars) (are spared, and the problem is global. For example, in the

Russian Federation and China, the estimated death rates per

100,000 population are five to ten times higher than in the USA

(mankind. For the above considerations and more, there is a compelling

need to accelerate efforts to interrogate the stroke process and

define the links that exist with other conditions such as vascular

and neurodegenerative dementia. It is also crucial to expand the

narrow repertoire of therapeutic opportunities for these devastating

conditions. To accomplish this, novel approaches are

required that expand upon our evolving mechanistic understanding

of the fundamentals of cell survival and death

processes as well as tissue repair. The future depends upon

how successful we are in deciphering these mechanisms and

bringing clarity to the complex interactions between the multiplicity

of cell and tissue types within brain (

with this knowledge and its successful therapeutic application,

the field of stroke could be transformed.

In this spirit then, this brief review addresses selected issues

fundamental to the science of ischemic stroke and vascular

dementia. It begins with posing questions about stroke risk

factors followed by a discussion of key cell and tissue mechanisms

that render brain susceptible as well as tolerant to

ischemic injury, including those promoting tissue protection

and repair. The review ends by highlighting promising treatment

strategies, inspired by these endogenous mechanisms, which

present the opportunity to open new avenues in stroke therapy.

Selected section titles are here;

Parenchymal Failure: Why and How Does the Brain Die during Ischemia?
Salvageable versus Nonsalvageable Tissue: Salvageable Tissue Is the Target for Therapy

What Are the Prominent Mechanisms Leading to Cell and Tissue Demise?

     Excitotoxicity
     Calcium Dysregulation
     Oxidative and Nitrosative Stress
     Cortical Spreading Depolarizations
      Inflammation
      Necrosis, Necroptosis, and Autophagy: The Execution

What Causes the White Matter Damage Underlying VCI?
Why Does Stroke Increase the Risk of Dementia? This is worth reading although we need prevention
How Does the Brain Repair Itself after Stroke?
Repair and Remodeling Processes after Stroke

Moving Forward: Charting a Course toward New Stroke Therapies

Additional Strategies for Repair and Recovery: Trophic Factors and Cell-Based Therapies

Someday I'll compare Dr. Moskowitz's theories with Dr. Clarkes Clarkes' stroke protocol
These two are the best I've seen and wonder why there aren't more references to them.We have to get away from the only acute stroke medication is tPA. Everyone of your doctors should know about this, my opinion only.