Deans' stroke musings: Five Things Physicians and Patients Should Question

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.

Friday, February 22, 2013

Five Things Physicians and Patients Should Question - American Academy of Neurology

I disagree with #2
http://www.aan.com/globals/axon/assets/10625.pdf
1. Don’t perform electroencephalography (EEG) for headaches.
EEG has no advantage over clinical evaluation in diagnosing headache, does not improve outcomes and increases cost. Recurrent headache is the
most common pain problem, affecting 15% to 20% of people.
2. Don’t perform imaging of the carotid arteries for simple syncope
without other neurologic symptoms. My dad had an endarterectomy at 85% blockage. His doctor should have told him to notify any children to get neck arteries scanned and put that info into a common stroke risk database. My carotid artery was estimated to be 80% blocked at the time of event and is now completely closed up. It was completely preventable with just a little proactive work on the doctors part. And there is no way to tell if that stroke risk is in any stroke prevention guideline.
Occlusive carotid artery disease does not cause fainting but rather causes focal neurologic deficits such as unilateral weakness. Thus, carotid imaging will not identify the cause of the fainting and increases cost. Fainting is a frequent complaint, affecting 40% of people during their lifetime. I had no symptoms, my dad did faint numerous times.
3. Don’t use opioid or butalbital treatment for migraine except as a
last resort.
Opioid and butalbital treatment for migraine should be avoided because more effective, migraine-specific treatments are available. Frequent use
of opioid and butalbital treatment can worsen headaches. Opioids should be reserved for those with medical conditions precluding the use of
migraine-specific treatments or for those who fail these treatments.
4. Don’t prescribe interferon-beta or glatiramer acetate to patients with
disability from progressive, non-relapsing forms of multiple sclerosis.
Interferon-beta and glatiramer acetate do not prevent the development of permanent disability in progressive forms of multiple sclerosis. These
medications increase costs and have frequent side effects that may adversely affect quality of life.
5. Don’t recommend CEA for asymptomatic carotid stenosis unless the
complication rate is low (&lt3%).
Based on studies reporting an upfront surgical complication rate ranging