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.

Friday, May 29, 2020

Confirmed ischemic stroke rates low in COVID-19

With this statement from an autopsy you would never see the damage from the micro-strokes on any imaging. 

Autopsies show this:

Translation: The lungs of the patients who died secondary to Covid-19 had wide-spread clotting, nine times more blood clots and blockages in the thousands of small capillaries and blood vessels in their lungs, compared with the lungs of patients who died from influenza. 

I would demand my doctor treat me as if I had a stroke; warfarin, tPA, Lovenox if I came in with COVID-19. But I'm not medically trained so don't listen to me.

Confirmed ischemic stroke rates low in COVID-19


Shadi Yaghi
Patients hospitalized with COVID-19 had low rates of ischemic stroke confirmed by imaging, according to a study published in Stroke.
The study also found that most strokes in these patients were cryptogenic and were linked to increased mortality.
“As centers develop protocols for the prompt triage and assessment of patients with COVID-19, the co-occurrence of stroke and COVID-19 should be considered when weighing these risks,” Shadi Yaghi, MD, FAHA, director of vascular neurology at NYU Langone Hospital-Brooklyn, director of clinical vascular neurology research at NYU Langone Health and assistant professor in the department of neurology at NYU Grossman School of Medicine, told Healio. “Second, stroke in the setting of COVID-19 could be a manifestation of systemic hypercoagulability as shown in our patient cohort with higher D-dimer levels when compared to patients who tested negative for the virus.”

COVID-19 in New York

Researchers analyzed data from patients who were hospitalized for COVID-19 in the New York metropolitan area between March 15 and April 19. Two control groups were formed in this study; a contemporary control group included patients with stroke and without COVID-19, and a historical control group included patients who were discharged with a diagnosis of ischemic stroke between March 15 and April 15.
All patients underwent a standard diagnostic evaluation per institutional protocol. Other information was abstracted from medical records including clinical and demographic variables, imaging variables, laboratory variables, discharge outcomes and in-hospital treatments. COVID-19 screening was performed at first provider contact.
Of the 3,556 patients who were hospitalized for COVID-19, 0.9% (n = 32; median age, 63 years; 72% men) had an ischemic stroke that was radiologically proven. The median time from the onset of COVID-19 symptoms to stroke identification was 10 days. Patients with COVID-19 and stroke were more likely to have cryptogenic stroke (65.6%) compared with the contemporary control (30.4%; P = .003) and historical control groups (25%; P < .001).
Compared with the contemporary control group, those with stroke and COVID-19 had higher peak D-dimer levels (> 10,000 ng/mL vs. 525 ng/mL; P = .011) and higher admission NIH Stroke Scale scores (19 vs. 8; P = .007). Patients with COVID-19 and stroke were more likely to be men (71.9% vs. 45%; P = .012) and had positive troponin levels (45.2% vs. 8.1%; P < .001), higher erythrocyte sedimentation rate levels (79 vs. 41; P = .001) and higher NIH Stroke Scale scores (19 vs. 3; P = .001) compared with the historical control group.

The mortality rate was higher in patients with COVID-19 and stroke compared with contemporary (63.6% vs. 9.3%; P < .001) and historical control groups (63.6% vs. 6.3%; P < .001).

Further research

“Studies are needed to determine the utility of therapeutic anticoagulation for stroke and other thrombotic event prevention in patients with COVID-19,” Yaghi said in an interview.
For the latest news on COVID-19 including case counts, information about the global public health response and emerging research, please visit the COVID-19 Resource Center on Healio.

For more information:

Shadi Yaghi, MD, FAHA, can be reached at shadiyaghi@yahoo.com; Twitter: @shadiyaghi2.
Disclosures: Yaghi reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

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