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.

Monday, June 4, 2018

Impact of Transcranial Doppler Ultrasound on Logistics and Outcomes in Stroke Thrombolysis

Way above my pay grade but you'll have to hope like hell your stroke hospital knows what the protocol for this should look like.
http://stroke.ahajournals.org/content/early/2018/05/25/STROKEAHA.118.021485?fl=4&cn=ZmxleGlibGVfcmVjc18y&refsrc=email

Results From the SITS-ISTR

Michael V. Mazya, Niaz Ahmed, Elsa Azevedo, Antoni Davalos, Laura Dorado, Michal Karlinski, Svetlana Lorenzano, Jiří Neumann, Danilo Toni, Tiago P. Moreira, on behalf of the SITS Investigators
https://doi.org/10.1161/STROKEAHA.118.021485
Stroke. 2018;STROKEAHA.118.021485
Originally published May 29, 2018

Abstract

Background and Purpose—Diagnostic transcranial Doppler ultrasound (TCD) is commonly used in patients with acute stroke before or during treatment with intravenous thrombolysis (IVT). We aimed to assess how much TCD delays IVT initiation and whether TCD influences outcomes.
Methods—We analyzed data from the SITS-ISTR (Safe Implementation of Thrombolysis in Stroke–International Stroke Thrombolysis Register) collected from December 2002 to December 2011. Outcomes were door-to-needle time, symptomatic intracerebral hemorrhage, functional outcome per the modified Rankin Scale, and mortality at 3 months.
Results—In hospitals performing any TCD pre-IVT, 1701 of 11 265 patients (15%) had TCD before IVT initiation. Door-to-needle time was higher in patients with pre-IVT TCD (74 versus 60 minutes; P<0.001). At hospitals performing any TCD during IVT infusion, of 9044 patients with IVT, 747 were examined with TCD during IVT. No treatment delay was seen with TCD during IVT. After multivariate adjustment, TCD during IVT was independently associated with modestly increased excellent functional outcome (modified Rankin Scale, 0–1; adjusted odds ratio, 1.28; 95% confidence interval, 1.06–1.55; P=0.012) and lower mortality (adjusted odds ratio, 0.73; 95% confidence interval, 0.55–0.95; P=0.022).
Conclusions—We recommend that TCD, if performed, should be done during IVT infusion, to avoid treatment delay. The association of hyperacute TCD with beneficial outcomes suggests potential impact on patient management, which warrants further study.
  • Received January 24, 2018.
  • Revision received April 23, 2018.
  • Accepted May 4, 2018.

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