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, June 11, 2019

Acute Cerebral CT Evaluation of Stroke Study (ACCESS)

You better hope as a young adult stroke person you even get to this stage. You better have classic stroke symptoms, drooping mouth, slurred speech, one side useless.

WRONG: PA Told MD It Was a 'Wine Headache' -- She Almost Died

Factors Associated With Misdiagnosis of Acute Stroke in Young Adults

Pediatric Stroke Often Misdiagnosed, Treatment Delayed

 

Doctors tell boy, 15, he had a migraine after rugby tackle - but he was actually suffering a paralyzing stroke which nearly killed him

The latest here:

Acute Cerebral CT Evaluation of Stroke Study (ACCESS)

ACCESS helps you to learn about how to read acute stroke CT scans. Participation also helps to increase the amount of data available on observer reliability.
ACCESS Acute Cerebral CT Evaluation in Stroke Study

REGISTER FOR ACCESS

  • We will send you a password with which to login to the ECCITING online teaching platform

LOGIN TO ACCESS

  • ACCESS was launched originally in 2004

Quick links

Background

ACCESS has been running continuously since 2004. Over 1,000 people have participated.
ACCESS is therefore one of the largest studies of observer reliability. It is definitely the largest study of observer reliability in stroke.
We describe results from the initial study in two papers:
  • Wardlaw JM, Farrall AJ, Perry D, von Kummer R, Mielke O, Moulin T, Ciccone A, Hill M, for the Acute Cerebral CT Evaluation of Stroke Study (ACCESS) Study Group. Factors influencing the detection of early computed tomography signs of cerebral ischemia. An internet-based, international multiobserver study. Stroke. 2007;38:1250-6. http://dx.doi.org/10.1161/01.STR.0000259715.53166.25
  • Wardlaw JM, von Kummer R, Farrall AJ, Chappell FM, Hill M, Perry D. A Large web-based observer reliability study of early ischaemic signs on computed tomography. The Acute Cerebral CT Evaluation Of Stroke Study(ACCESS). PLoS ONE. 2010;5:e15757. http://dx.doi.org/10.1371/journal.pone.0015757

Participation

ACCESS helps you to learn about how to read acute stroke CT scans. It has been used for training:
  • Third International Stroke Trial (IST-3) centres
  • IST-3 expert scan reading panel members
  • British Society of Neuroradiologists (BSNR) doctors in training
  • British Association of Stroke Physicians (BASP) doctors in training
Participation also helps to increase the amount of data available on observer reliability.
Participation is eligible for CPD / CME.
If you are introducing a new thrombolysis service or are likely to be working in a unit where you will see many acute stroke patients, & you feel that your scan reading skills are either rusty or have never been developed in the first place, then completing ACCESS is a quick way of helping to bring yourself up to speed.

Key findings

Data from ACCESS have been used to understand ways of improving observer confidence in interpreting hyperacute stroke CT scans. For example:
  • observers rarely see early infarcts signs that are not present (i.e. the false positive rate is low)
  • the most reliably recognised sign is the hyperattenuated artery
  • more experienced observers read scans more slowly
  • taking longer to read scans improves observer performance
  • old lesions are distracting because they draw your attention away from acute lesions
  • use of any visual rating scale helps improve observer performance

Thanks

We'd like to thank everybody who has contributed to this work so far. Hopefully you have found it to be beneficial to your practice.
Please recommend ACCESS to your friends and colleagues.

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