Deans' stroke musings: Silent brain infarction and risk of future stroke

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, March 14, 2017

Silent brain infarction and risk of future stroke

My doctor told me I had multiple small infarcts in my white matter. Of course he never showed me anything to prove that assertion or did one damn thing to correct the problems from that. It was basically, you're screwed, deal with this on your own, I know and will do nothing.

Silent brain infarction and risk of future stroke

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Stroke, 03/11/2016Gupta A, et al.

The authors performed a systematic review and meta–analysis to summarize the association between magnetic resonance imaging–defined silent brain infarction (SBI) and future stroke risk. SBI is present in ≈1 in 5 stroke–free older adults and is associated with a 2–fold increased risk of future stroke. Future studies of in–depth stroke risk evaluations and intensive prevention measures are warranted in patients with clinically unrecognized radiologically evident brain infarctions.

Methods

The authors searched the medical literature to identify cohort studies involving adults with SBI detected by magnetic resonance imaging who were subsequently followed up for incident clinically defined stroke.
Study data and quality assessment were recorded in duplicate with disagreements in data extraction resolved by a third reader.
Strength association between magnetic resonance imaging-detected SBI and future symptomatic stroke was measured by an hazard ratio.

Results

The meta-analysis included 13 studies (14 764 subjects) with a mean follow-up ranging from 25.7 to 174 months.
SBI predicted the occurrence of stroke with a random effects crude relative risk of 2.94 (95% confidence interval, 2.24-3.86, P<0.001; Q=39.65, P<0.001).
In the 8 studies of 10 427 subjects providing hazard ratio adjusted for cardiovascular risk factors, SBI was an independent predictor of incident stroke (hazard ratio, 2.08 [95% confidence interval, 1.69-2.56; P<0.001]; Q=8.99; P=0.25).
In a subgroup analysis pooling 9483 stroke-free individuals from large population-based studies, SBI was present in ≈18% of participants and remained a strong predictor of future stroke (hazard ratio, 2.06 [95% confidence interval, 1.64-2.59]; P<0.01).

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