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.

Tuesday, January 12, 2016

Reperfusion Beyond 6 Hours Reduces Infarct Probability in Moderately Ischemic Brain Tissue

So from this could we calculate the death rate of neurons during the week or so that the neuronal cascade of death is occurring? We never will solve that problem unless we can quantify the neurons dying per minute. 1.9 million neurons dying per minute in stroke focused attention on speed of intervention. 
http://stroke.ahajournals.org/content/47/1/99.abstract?sid=9902c2fc-fc05-40fb-b6dc-2e313e0096c5
  1. Jin-Moo Lee, MD, PhD
+ Author Affiliations
  1. From the Mallinckrodt Institute of Radiology (H.A., C.E., K.D.V., J.-M.L.) and Department of Neurology (A.L.F., Y.C., J.-M.L.), Washington University, School of Medicine; and Department of Biostatistics (H.Z.), Department of Neurology (W.J.P., W.L.), and Department of Radiology (W.L.), University of North Carolina at Chapel Hill.
  1. Correspondence to Jin-Moo Lee, MD, Washington University, School of Medicine, Department of Neurology, 600 South Euclid Ave, Campus Box 8111, Saint Louis, Missouri 63110, E-mail leejm@neuro.wustl.edu or Weili Lin, PhD, University of North Carolina, 106 Mason Farm Rd, Campus Box 7515, Chapel Hill, NC 27599, E-mail weili_lin@med.unc.edu
  1. * Drs An and Ford contributed equally.

Abstract

Background and Purpose—We aimed to examine perfusion changes between 3 and 6 and 6 and 24 hours after stroke onset and their impact on tissue outcome.
Methods—Acute ischemic stroke patients underwent perfusion magnetic resonance imaging at 3, 6, and 24 hours after stroke onset and follow-up fluid-attenuated inversion recovery at 1 month to assess tissue fate. Mean transit time prolongation maps (MTTp=MTT–[median MTT of contralateral hemisphere]) were obtained at 3 (MTTp3 h), 6 (MTTp6 h), and 24 hours (MTTp24 h). Perfusion changes between 3 and 6 hours (ΔMTTp3_6) and 6 and 24 hours (ΔMTTp6_24) were calculated. A 2-step analysis was performed to evaluate the impact of ΔMTTp3_6 and ΔMTTp6_24 on tissue fate. First, a voxel-based multivariable logistic regression was performed for each individual patient with MTTp3 h, ΔMTTp3_6, and ΔMTT6_24 as independent variables and tissue fate as outcome. Second, Wilcoxon signed-rank tests on logistic regression coefficients were performed across patients to evaluate whether ΔMTTp3_6 and ΔMTT6_24 had significant impact on tissue fate for varying severities of baseline perfusion.
Results—Perfusion change was common during both time periods: 85% and 81% of patients had perfusion improvement during 3- to 6- and 6- and 24-hour time intervals, respectively. ΔMTT3_6 significantly influenced 1-month infarct probability across a wide range of baseline perfusion (MTTp 0–15 s). ΔMTT6_24 also impacted 1-month infarct probability, but its influence was restricted to tissue with milder baseline ischemia (MTTp 0–10 s).
Conclusions—Brain tissue with mild to moderate ischemia can be salvaged by reperfusion even after 6 hours. Such tissue could be targeted for intervention beyond current treatment windows.

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