Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 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:

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's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Thursday, July 28, 2016

Catheter-Based Closure Not Recommended for Patients With Heart Defect, Stroke

Popular news here, dumping all the risk on the patient.If you want the closure it means you will have to out argue your medical staff and insurance company. Be prepared.
http://dgnews.docguide.com/catheter-based-closure-not-recommended-patients-heart-defect-stroke?
MINNEAPOLIS, Minn -- July 27, 2016 -- An updated recommendation from the American Academy of Neurology (AAN) states that catheter-based closure should not be routinely recommended for people who have had a stroke and also have a patent foramen ovale (PFO).
The practice advisory, which updates a previous AAN guideline, is published in the July 27, 2016, online issue of the journal Neurology.
To develop the advisory, researchers reviewed all available scientific studies on people with PFO who also had an ischemic stroke or a transient ischemic attack (TIA).
“Compared with other ways to prevent a second stroke, such as medications to reduce blood clots, the devices used to close a patent foramen ovale have limited evidence to support their use,” said practice advisory author Steven R. Messé, MD, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. “It’s still uncertain how effective these devices are in reducing stroke risk, and the procedure is associated with uncommon but potentially serious complications.”
In addition, Dr. Messé noted that the devices used for PFO closure are not available for routine use in the United States, so the procedure must be done off-label with a device approved for treating a similar heart defect or with another device that does not have strong evidence regarding its use. At the time of publication, the US Food and Drug Administration (FDA) is currently reviewing the one device that has the best evidence regarding closure.
“People should know that having a PFO is common -- 1 in 4 people have one -- and the risk of having a second stroke is low,” said Dr. Messé. (Well shit, Dr. Messé you are not the person at risk for a stroke.You can blithely talk about it without consequence.)
When the AAN developed the earlier guideline on this topic in 2004, not enough evidence was available to make a recommendation on whether closing a PFO was effective in reducing stroke risk.
The advisory also recommends that aspirin or other antiplatelet drugs be used to prevent blood clots instead of blood thinners unless there is another reason to use blood thinners, such as a person with a history of blood clots in the legs or lungs.
SOURCE: American Academy of Neurology

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