http://www.dana.org/media/detail.aspx?id=44906
Few medical conditions, neurological or otherwise, exact a greater public-health toll than stroke, a fact underscored by a new published report on the global burden of stroke. An acute brain injury that may begin insidiously years prior, stroke is now the second leading cause of death and the third most common cause of disability worldwide. Nearly 17 million people in the world will have a first stroke in the next year, and 33 million people are stroke survivors.
In the U.S., stroke is the No. 1 cause of serious long-term disability. Approximately 800,000 strokes occur annually in this country, and about 130,000 people die annually from stroke. The risk of stroke has decreased by roughly 70 percent in the U.S. since incidence was first tracked in the mid-1900’s, a downward trend that has not plateaued, suggesting there is still room for improvement. Stroke risk factors are well known, and experts estimate that 80 percent of strokes could be prevented with better management of hypertension, blood lipids, and glucose.
Getting Aggressive About Prevention
“Most people believe there could be substantial, dramatic stroke reduction if we just really aggressively managed the risk factors we currently know about,” says Walter Koroshetz, M.D., deputy director of the National Institute for Neurological Disorders and Stroke and a member of the Dana Alliance for Brain Initiatives. “In many diseases, you need a major scientific breakthrough to make a difference. That’s not true with stroke.”
Except you could reduce stroke risk by hundreds of percents following these;
Green tea and coffee 20% - Green tea, coffee may reduce stroke risk by 20 percent
Potassium 21% Why eat three bananas a day?
Marijuana buds 50% A Marijuana Bud A Day Keeps The Stroke Away
Dietary magnesium 8% Higher magnesium intake associated with reduced ischemic stroke risk
Mediterranean diet 30% - Mediterranean Diet Proven Key In Avoiding Heart Disease And Strokelycopene - tomatoes 55% -Tomatoes Linked to Lower Stroke Risk
Fish 6% - Does Eating Two Fish a Day REALLY Keep the Chance of Stroke Away?
Walking 43% - Walking wards off stroke for women
Speed walking 50% - Speed Walking Halves Stroke Risk
Dietary fiber 7% - More Dietary Fiber Might Help Thwart Stroke
Total 307% Dietary fiber 7% - More Dietary Fiber Might Help Thwart Stroke
Opening the Window for Acute Treatment
Public-health advocates have tried for years to drive home the message that strokes require immediate medical attention, ever since a treatment became available that could help some people with ischemic stroke, which occurs when blood flow to part of the brain is restricted by a clot or narrowed blood vessel. Tissue plasminogen activator, or tPA, is still the only drug approved for treating acute stroke, but its use is severely limited, largely because published guidelines call for it to be administered within three hours of stroke onset for most patients. Some experts have criticized these guidelines and are calling for them to be revised.
With a pathetic 12% efficacy that means that they are lying about 88% of the results
Public Awareness Still Lacking
The advent of tPA has triggered a system-wide reorganization of stroke urgent care that is still evolving nearly 17 years later. For example, specialized stroke centers have been established where expert care, along with the tools and technologies for swift, accurate diagnosis, is readily available. A tiered system based on minimum requirements, much like the system that designates hospitals as Level 1-4 trauma centers depending on their capabilities, is being put in place for stroke care as well, so that patients can be transported to the most advanced center in their area. While there have been vast improvements, a number of obstacles remain. Primary among them is public awareness, experts say.
“Public knowledge about stroke is still very low,” says Caplan. “This is the more difficult problem, because a lot of people don’t know they’ve had a stroke.”
The real problem here is that there is no easy objective way to diagnose a stroke. Friends have been in ERs for hours because the stroke hadn't established severe enough effects to be obvious. That should be accomplished with the tricorder possibly thru one of these 17 ways.
Better Rehab Through Brain Science
The Global Burden of Disease report underscores the dichotomy between richer, developed countries like the U.S., where the majority of people who suffer a stroke survive, and poorer, developing countries where people are more likely to die from a stroke. While cutting stroke deaths is a major global-health goal, better recovery and rehabilitation strategies are desperately needed to address the ever-growing population of stroke survivors who struggle to function with varying degrees of disability.
“We have in the U.S. alone 800,000 people who have a stroke each year. So the question becomes, what can be done to return functional recovery to those patients?” says Koroshetz. “That’s where the really interesting science is, because it intersects with the area of neuroplasticity–how the brain learns to function for a particular purpose and how it rewires itself to get lost function back.”
You have this all wrong, you need to stop the neuronal cascade of death resulting in much less death and disability. The silo of rehabilitation is not where the breakthroughs are going to occur because no one knows exactly how to make neuroplasticity repeatable.
Brain Recovery Not Passive
Armed with such investigational tools, neuroscience has already revealed some fundamental principles of recovery in the brain. “The general rule, at least in the cortex, is that somehow the brain recovers function after an initial injury, whether it’s a stroke or some other lesion,” says Koroshetz. “Now people are studying how that happens, and the hope is that we can translate that to therapeutic strategies.”
One key finding already, Koroshetz says, is that recovery from injury is not “passive.” Rather, it requires enhancement by active exposure to sensory stimuli or motor practice. He points to the LEAPS study, which was the first large randomized, controlled clinical trial that investigated recovery of locomotor function in people who had had a stroke. The NIH-funded study compared two fairly intensive therapies: treadmill walking vs. strength and balance training performed at home with a physical therapist. A third group, serving as controls, received “standard of care”–whatever physical therapy or rehab they were getting as part of their regular medical care.
‘Standard of Care’ Substandard?
What the hell is the standard of care for stroke? Does anyone know?
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