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, November 28, 2017

Reconsidering Neuroprotection in the Reperfusion Era

So WHOM  is going to create a strategy to solve the neuronal cascade of death(neuroprotection) problem? And lead that strategy to a successful conclusion?
http://stroke.ahajournals.org/content/48/12/3413?etoc=

Sean I. Savitz, Jean-Claude Baron, Midori A. Yenari, Nerses Sanossian, Marc Fisher
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Neuroprotection to prevent infarct progression as a potential treatment for acute ischemic stroke carries a long and disappointing history. The failures of these prior neuroprotection trials have many potential explanations that encompass both problems with the preclinical assessment of these drugs and the design/implementation of clinical trials.1 Prior development of neuroprotection has focused primarily on its use as a monotherapy, and no clinical trial was designed to determine whether neuroprotection could extend the time window for successful reperfusion or ameliorate the consequences of reperfusion. Acute stroke therapy has now entered the era of highly effective reperfusion with the recent publication of 5 positive thrombectomy trials.2 Combining neuroprotection with intravenous or intra-arterial reperfusion therapy is now an important next step in the development of acute stroke therapies. One approach to neuroprotection would be to initiate therapy early after ischemic stroke onset, either in the ambulance or at a primary stroke center/community hospital to potentially extend the time window for intravenous or intra-arterial therapy. A second approach would be to use neuroprotection during or after partial or complete reperfusion to reduce the consequences of reperfusion injury. Both future neuroprotective approaches will require preclinical studies that anticipate novel clinical trial designs and trials that will be organized and evaluated differently than past monotherapy neuroprotection trials.

Ischemic Penumbra and Core

Acute ischemic stroke therapy is designed to reduce infarction of hypoperfused brain tissue and limit the expansion of already irreversibly injured tissue when treatment is initiated, leading to smaller infarction and improved clinical outcomes.3,4 Severely hypoperfused but still potentially viable ischemic brain represents the ischemic penumbra, whereas irreversibly injured tissue is the ischemic core.5 Early after stroke onset, most patients with a large vessel occlusion (LVO) have an extensive ischemic penumbra that can be salvaged by timely reperfusion. This concept was proven …
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1 comment:

  1. Withholding treatment from the control group would be the clearest test of a new treatment BUT WHO WOULD VOLUNTEER FOR THAT?

    ReplyDelete