Deans' stroke musings: The Pathophysiology of Delayed Cerebral Ischemia

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.

Saturday, June 11, 2016

The Pathophysiology of Delayed Cerebral Ischemia

You will have to ask your stroke hospital what is their protocol to prevent this delayed ischemia after hemorrhage. Because no one ever seems to publicly post protocols for stroke or even the ones their hospital is using, you have NO FUCKING IDEA how good your hospital is. They prefer that because if you knew how fucking bad their stroke patients recover you would raise a hue and cry to the board of directors to hire some decent competent people.
http://journals.lww.com/clinicalneurophys/Abstract/2016/06000/The_Pathophysiology_of_Delayed_Cerebral_Ischemia.2.aspx

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Journal of Clinical Neurophysiology:

June 2016 - Volume 33 - Issue 3 - p 174–182

doi: 10.1097/WNP.0000000000000273

Invited Review

The Pathophysiology of Delayed Cerebral Ischemia

Foreman, Brandon

Abstract

Summary: Subarachnoid hemorrhage (SAH) affects 30,000 people in the Unites States alone each year. Delayed cerebral ischemia occurs days after subarachnoid hemorrhage and represents a potentially treatable cause of morbidity for approximately one-third of those who survive the initial hemorrhage. While vasospasm has been traditionally linked to the development of cerebral ischemia several days after subarachnoid hemorrhage, emerging evidence reveals that delayed cerebral ischemia is part of a much more complicated post–subarachnoid hemorrhage syndrome. The development of delayed cerebral ischemia involves early arteriolar vasospasm with microthrombosis, perfusion mismatch and neurovascular uncoupling, spreading depolarizations, and inflammatory responses that begin at the time of the hemorrhage and evolve over time, culminating in cortical infarction. Large-vessel vasospasm is likely a late contributor to ongoing injury, and effective treatment for delayed cerebral ischemia will require improved detection of critical early pathophysiologic changes as well as therapeutic options that target multiple related pathways.