The review should have discussed all the failures in stroke rather than lying about the progress in stroke. I see zero progress in stroke. All this left to solve and no one trying to solve them.
The status quo in stroke is a complete failure.
1. Only 10% of patients get to full recovery.
2. tPA only fully works to reverse the stroke 12% of the time. Known since 1996.
3. No protocols to prevent your 33% dementia chance post-stroke from an Australian study.
4. Nothing to alleviate your fatigue.
5. Nothing that will cure your spasticity.
6. Nothing on cognitive training unless you find this yourself.
7. No published stroke protocols.
8. No way to compare your stroke hospital results vs. other stroke hospitals.
The Management of Acute Ischemic Stroke
Until recently, recombinant tissue plasminogen activator (r-tPA) was the
only acute ischemic stroke treatment. However, only 4–8% of patients
with ischemic stroke truly receive r-tPA, in part due to the limited
time window for treatment. In 2008, the ECASS-3 trial prolonged the
window for r-tPA eligibility from 3 to 4.5 hours after symptom onset,
with additional exclusion criteria which increased r-tPA
utilization by as much as 20% in some centres. In 2015, the
introduction of advanced endovascular treatment methods further expanded
this treatment window to select patients to up to 7 hours from symptom
onset. Rapid assessment of suspected stroke patients to regulate
eligibility for these treatments, therefore, remains a critical step.
Systems and courses to efficiently identify suspected stroke patients as
early as possible and quickly deliver acute reperfusion therapy are now
commonplace. Further technological advances using tele-stroke and
mobile stroke units in the prehospital setting have increased r-tPA
utilization and reduced delays to treatment. This review will discuss
the most recent progress in acute stroke treatment and improved systems
for their delivery in current practice.
No comments:
Post a Comment