Deans' stroke musings: The fate of hypoxic tissue on 18F-fluoromisonidazole positron emission tomography after ischemic stroke

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.

Wednesday, September 7, 2011

The fate of hypoxic tissue on 18F-fluoromisonidazole positron emission tomography after ischemic stroke

In simpler words, they were using PET scans to see how much hypoxic tissue died in the penumbra.
http://onlinelibrary.wiley.com/doi/10.1002/1531-8249(200008)48:2%3C228::AID-ANA13%3E3.0.CO;2-B/abstract

Abstract

We studied 24 patients up to 51 hours after ischemic stroke using ¹⁸F-fluoromisonidazole positron emission tomography to determine the fate of hypoxic tissue likely to represent the ischemic penumbra. Areas of hypoxic tissue were detected on positron emission tomography in 15 patients, and computed tomography was available in 12 patients, allowing comparison with the infarct volume to determine the proportions of the hypoxic tissue volume that infarcted and survived. The proportion of patients with hypoxic tissue and the amount of hypoxic tissue detected declined with time. On average, 45% of the total hypoxic tissue volume survived and 55% infarcted. Up to 68% (mean, 17.5%) of the infarct volume was initially hypoxic. Most of the tissue “initially affected” proceeded to infarction. We correlated hypoxic tissue volumes with neurological and functional outcome assessed using the National Institutes of Health Stroke Scale, Barthel Index, and Rankin Score. Initial stroke severity correlated significantly with the “initially affected” volume, neurological deterioration during the first week after stroke with the proportion of the “initially affected” volume that infarcted, and functional outcome with the infarct volume. Significant reductions in the size of the infarct and improved clinical outcomes might be achieved if hypoxic tissue can be rescued. Ann Neurol 2000;48:228–235

This is extremely interesting to me since I got tPA so fast and still ended up with a massive dead area. I have yet to be able decipher my initial scans since they were CT scans as compared to the MRI scan that is on this site. This is why I am pushing so hard on additional hyperacute therapies.