Info if this applies to you. Doctor question.
http://dgnews.docguide.com/low-blood-flow-back-brain-increases-risk-recurrent-stroke?
Patients who have had a stroke in the back of the brain are at
greater risk of having another within 2 years if blood flow to the
region is diminished, according to a study published in JAMA Neurology.
These patients are the most likely to benefit from risky intervention
to unblock arteries, and they can be identified using a new magnetic
resonance imaging (MRI)-based technology developed at the University of
Illinois at Chicago, Chicago, Illinois.
“Having a blockage present in a blood vessel doesn’t always correlate
to low blood flow,” said principal investigator Sepideh Amin-Hanjani,
MD, University of Illinois at Chicago College of Medicine. “There can be
a blockage and flow can be normal, if other nearby blood vessels are
able to compensate.”
The researchers wanted to try to identify which patients who had
experienced a stroke were at highest risk for further strokes and so
might benefit from angioplasty despite the risks of the procedure.
They followed 72 adult patients who had a stroke or a transient
ischemic attack (TIA) in the back of the brain and who also had at least
50% blockage of the arteries in that part of the brain. The patients
were followed for an average of 22 months at 5 academic medical centres
as they continued receiving standard care for their condition from their
neurologists.
Patients were evaluated for reduced blood flow in the back of the
brain using Non-Invasive Optimal Vessel Analysis (NOVA), a software
program that can quantify the volume, velocity, and direction of blood
flowing through any major vessel in the brain using standard MRI
equipment.
One-fourth of the patients were found to have diminished blood flow
in the back of the brain, which turned out to be a significant predictor
of subsequent stroke. These patients had 12- and 24-month stroke-free
survival rates of 78% and 70%, respectively, compared to 96 percent and
87 percent for patients with normal blood flow.
“At 1 year, the risk for patients with low blood flow was about 5
times as high as risk for patients without low flow in the back of the
brain,” said Dr. Hanjani.
For these patients, the benefits of angioplasty probably outweigh the risks.
“About three-quarters of patients didn't have low blood flow in the
vertebrobasilar region and these patients would not benefit from
treatments aimed at opening the vessels, such as angioplasty,” said Dr.
Hanjani. “In fact, the procedure would put these patients at unnecessary
risk.”
The ultimate goal is to find what treatments might be most effective for each patient, he added.
The researchers hope that the ease of identifying the high-risk group
using NOVA will enable further study of the condition and the
evaluation of new therapies to further reduce the risk of recurrent
stroke.
SOURCE: University of Illinois at Chicago
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