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.

Thursday, September 13, 2018

Association of clinical, imaging, and thrombus characteristics with recanalization of visible intracranial occlusion in patients with acute ischemic stroke

You are testing for the wrong measure you blithering idiots. 100% recovery is the goal NOT recanalization. This is precisely why stroke survivors need to be in charge, they won't take the easy way out and settle for crapola like this.
https://www.mdlinx.com/journal-summaries/acute-ischemic-stroke-computed-tomographic-angiography/2018/09/13/7544241/ZZ3559DFF1FDFD43F3965FF05AF76C7B18?

JAMA — Menon BK, et al. | September 13, 2018
In patients with ischemic stroke treated with intravenous alteplase or not treated with alteplase, researchers tested recanalization over time across a range of intracranial thrombus occlusion sites and clinical and imaging characteristics in this multicenter prospective cohort study. Findings suggested an association of more distal thrombus location, greater thrombus permeability, and longer time to recanalization assessment with recanalization of arterial occlusion after administration of intravenous alteplase in patients with acute ischemic stroke. It was noted that rates of arterial recanalization were low among patients who did not receive alteplase. In patients with acute ischemic stroke, these findings might help inform treatment and triage decisions.

Methods

  • Study participants were 575 subjects from 12 centers (in Canada, Spain, South Korea, the Czech Republic, and Turkey) with acute ischemic stroke and intracranial arterial occlusion demonstrated on computed tomographic angiography (CTA).
  • Main exposures analyzed were demographics, clinical characteristics, time from alteplase to recanalization, and intracranial thrombus characteristics (location and permeability) defined on CTA.
  • Main outcomes and measures analyzed were recanalization on repeat CTA or on first angiographic acquisition of affected intracranial circulation obtained within 6 hours of baseline CTA, characterized utilizing the revised arterial occlusion scale (rAOL) (scores from 0 [primary occlusive lesion remains the same] to 3 [complete revascularization of primary occlusion]).

Results

  • The study results showed that among 575 subjects (median age, 72 years [IQR, 63-80]; 51.5% men; median time from patient last known well to baseline CTA of 114 minutes [IQR, 74-180]), 275 patients (47.8%) received intravenous alteplase only, 195 (33.9%) received intravenous alteplase plus endovascular thrombectomy, 48 (8.3%) received endovascular thrombectomy alone, and 57 (9.9%) received conservative treatment.
  • It was noted that median time from baseline CTA to recanalization assessment was 158 minutes (IQR, 79-268).
  • Median time from intravenous alteplase start to recanalization assessment was 132.5 minutes (IQR, 62-238).
  • Findings revealed that successful recanalization occurred at an unadjusted rate of 27.3% (157/575) overall, including in 30.4% (143/470) of patients who received intravenous alteplase and 13.3% (14/105) who did not (difference, 17.1% [95% CI, 10.2%-25.8%]).
  • The following factors were related to recanalization: time from treatment start to recanalization assessment (OR, 1.28 for every 30-minute increase in time [95% CI, 1.18-1.38]), more distal thrombus location, eg, distal M1 middle cerebral artery (39/84 [46.4%]) vs internal carotid artery (10/92 [10.9%]) (OR, 5.61 [95% CI, 2.38-13.26]), and higher residual flow (thrombus permeability) grade, eg, hairline streak (30/45 [66.7%]) vs none (91/377 [24.1%]) (OR, 7.03 [95% CI, 3.32-14.87]) among patients receiving alteplase.
Read the full article on JAMA
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