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:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Tuesday, March 5, 2013

Eye-Tracking Tool Might Quickly Spot Stroke

Another tool to be compared against these fifteen for easy diagnosis.
http://www.doctorslounge.com/index.php/news/hd/36236
The key to correctly diagnosing when a case of dizziness is just vertigo or a life-threatening stroke may be surprisingly simple: a pair of goggles that measures eye movement at the bedside in as little as one minute, a new study contends.
"This is the first study demonstrating that we can accurately discriminate strokes and non-strokes using this device," said Dr. David Newman-Toker, lead author of a paper on the technique that is published in the April issue of the journal Stroke.
Some 100,000 strokes are misdiagnosed as something else each year in the United States, resulting in 20,000 to 30,000 deaths or severe physical and speech impairments, the researchers said.
As with heart attacks, the key to treating stroke and potentially saving a person's life is speed. Magnetic resonance imaging (MRI), the current gold standard for assessing stroke, can take up to six hours to complete and costs $1,200, said Newman-Toker, who is an associate professor of neurology and otolaryngology at Johns Hopkins Hospital in Baltimore.
Sometimes people don't even get as far as an MRI, and may be sent home with a first "mini stroke" that is followed by a devastating second stroke, he added.
The new study findings come with some significant caveats, however.
For one thing, the study was a small one, involving only 12 patients.
"It is impossible for a small study to prove 100 percent accuracy," said Dr. Daniel Labovitz, director of the Stern Stroke Center at Montefiore Medical Center in New York City, who was not involved with the study. About 4 percent of dizziness cases in the emergency room are caused by stroke.
The other caveat is that the device is not yet approved in the United States for diagnosing stroke. The U.S. Food and Drug Administration only recently gave it approval for use in assessing balance. It has been available in Europe for that purpose for about a year.
The device -- known as a video-oculography machine -- is a modification of a "head impulse test," which is used regularly for people with chronic dizziness and other inner ear-balance disorders.
"There are 500 otolaryngologists and 4 million dizzy patients in the U.S. alone," Newman-Toker said. "We [otolaryngologists] can't see everybody and [emergency room physicians] can't easily be trained to develop expertise in eye movement interpretation."
"Now we have a device that can do it for them," he added.
The test is simple to perform: Wearing a pair of goggles hooked up to a webcam and special software, the patient is asked to focus on one spot on the wall while the doctor moves the patient's head from side to side.
"Normally, the balance system in the ears keeps our eyes stable when our head is moving," Newman-Toker explained.
For people with vertigo, the test is "almost always abnormal," he said. But stroke patients, even though they have the same dizzy symptoms, don't have this impairment.
In this small, "proof-of-concept" study, the test was 100 percent accurate when compared with MRI, sorting out six people with strokes and six without, the researchers said.
Newman-Toker believes the test could one day be incorporated into a smartphone application.
Labovitz said the device could be a "game changer" if its value is confirmed in larger studies. "This is such an important area where we struggle all the time," he said.
GN Otometrics, which makes the device, loaned the devices for the study, but the research was funded by the U.S. National Institutes of Health and other Swiss and U.S. health organizations.

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