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, August 25, 2014

Does “Time Is Brain” Also Mean “Time Is Clot”?

Damn, these idiots think that recanalization is the endpoint, it's not,
saving neurons is the endpoint. You damned idiots aren't even solving the right problem.   Solve the neuronal cascade of death.
http://stroke.ahajournals.org/content/45/9/2555.extract?etoc

Time Dependency of Tissue-Type Plasminogen Activator–Induced Recanalization in Acute Ischemic Stroke

  1. Andrei V. Alexandrov, MD
+ Author Affiliations
  1. From the Second Department of Neurology, University of Athens, School of Medicine, “Attikon” University Hospital, Athens, Greece (G.T.); Department of Neurology, The University of Tennessee Health Science Center, Memphis (G.T., A.V.A.); and International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic (G.T.).
  1. Correspondence to Andrei V. Alexandrov, MD, FAHA, Department of Neurology, The University of Tennessee Health Science Center, 855 Monroe Ave, Suite 415, Memphis, TN 38163. E-mail avalexandrov@att.net
Key Words:
See related article, p 2734.
Pooled analyses of major randomized controlled trials of intravenous thrombolysis (IVT) in acute ischemic stroke (AIS)13 have established the clinical dictum of “Time is Brain”4 because longer times from stroke symptom onset to the initiation of IVT are associated with a lower likelihood of good clinical outcomes at 3 months. Recanalization could be the main mechanism why this time dependency is seen, and the so-called recanalization hypothesis is supported by evidence from a meta-analysis of clinical studies that documented recanalization.5 However, no prospective study to date has demonstrated that indeed shorter onset-to-treatment times (OTTs) result in shorter time to recanalization of an intracranial occlusion, in turn proving it to be the key link to better long-term functional outcomes. Conversely, could this also mean that longer times to treatment produce less recanalization attributable to clot maturation and progression of ischemic injury to brain tissues? Could “Time is Brain” also mean “Time is Clot”? As time is lost, clot wins.
In several pilot single-center studies of real-time monitoring of tissue-type plasminogen activator (tPA) infusion by transcranial Doppler (TCD), both the elapsed time from symptom onset to recanalization6 and the speed of clot lysis7 with IVT thrombolysis were associated with early clinical recovery from AIS as determined by serial National Institutes of Health Stroke Scale assessments. Nevertheless, the effect of the temporal profile of recanalization on 3-month functional outcome after adjusting for potential prognostic factors remains unknown.
In this issue …

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