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

Friday, August 5, 2016

Potential of Stimulants to Augment Rehabilitation i n the Acute Stroke Setting: Preliminary Support

Maybe these also? This joins marijuana, ecstasy and levodopa as possible help in stroke recovery.

https://www.researchgate.net/profile/Karen_Albright2/publication/282590626_Potential_of_Stimulants_to_Augment_Rehabilitation_in_the_Acute_Stroke_Setting_Preliminary_Support/links/56a6bedc08aeded22e3545e2.pdf
enny M. Ngo
1
, Michael Korsmo
1
, Karen C. Albright
2,3
, Mansi M. Jhaveri
4,5
,
Ramy E. l. Khoury
1
and Sheryl Martin-Schild
1*
1
Department of Neurology, Tulane University Hospital,
New Orleans, LA 70112, United States.
2
Department of Epidemiology, School of Public Health,
University of Alabama at Birmingham,
Alabama, United States.
3
Geriatric Research, Education, and Clinical Center (G
RECC), Birmingham Veteran Affairs,
Birmingham, Alabama 35233 United States.
4
Department of Physical Medicine and Rehabilitation, Un
iversity of Texas Health Sciences Center at
Houston, Houston, Texas 77030, United States.
5
Department of Neurology, University of Texas Health Scie
nces Center at Houston, Houston,
Texas 77030, United States. 
DOI: 10.9734/INDJ/2016/20621
Editor(s):
(1) Zhefeng Guo, Department of Neurology, Universit
y of California, Los Angeles, USA.
Reviewers:
(1)
Adria Arboix, University of Barcelona, Spain.
(2)
Xing Li, Mayo Clinic, USA.
Complete Peer review History:
http://sciencedomain.org/review-history/11571
Received 1
st
August 2015
Accepted 2
nd
September 2015
Published 27
th
September 2015
Case Study
Ngo et al.; INDJ, 5(1): 1-6, 2016; Article no.INDJ.
20621
2
ABSTRACT
Aims:
The objective of these case studies is to explore the possibility of using neurostimulants
during the acute stage of stroke to facilitate effective rehabilitation of patients with severe strokes.
Presentation of Cases:
In Case 1, methylphenidate was administered to a 63 year old woman with a left anterior cerebral artery infarct who was discharged to inpatient rehabilitation, rather than
original recommendation of skilled nursing facility, prior to returning home. In Case 2, modafinil was administered to a 56 year old man with a left middle cerebral artery infarct who was discharged to inpatient rehabilitation prior to returning home. In Case 3, modafinil was administered to a 66 year old man with a left middle cerebral arery infarct who was discharged to inpatient rehabilitation. In Case 4, modafinil and methylphenidate were co-administered to a patient with a hypertensive intracerebral hemorrhage who experienced an adverse event possibly related to neurostimulants resulting in discontinuation. She was discharged to
inpatient rehabilitation and subsequently to a skilled nursing facility.
Discussion: All cases initially presented to therapists with barriers to inpatient rehabilitation.
Following neurostimulant administration, therapies recommended discharge to inpatient
rehabilitation facility due to improvement in initial barriers. Three out of the four cases tolerated the neurostimulant well, while one case required discontinuation due to an adverse event.
Conclusion: Patients with severe strokes are less likely to meet criteria for inpatient rehabilitation. Depressed consciousness and limited attention are major barriers for which neurostimulants may be of benefit in the acute post-stroke setting. Administration of neurostimulants may improve participation in therapy, thus increasing qualification for inpatient rehabilitation, and ultimately accelerate recovery. Safety data in this population during the acute stage of stroke are lacking.

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