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.

Wednesday, June 10, 2020

Brain Bleeds on Steady Trend Upward

The takeaway from this is quite simple. 

1. Update the stroke strategy to solve the hemorrhage cascade of death

2. Assign researchers to solve that problem.

3. Get the Nobel prize in Medicine

But NOTHING WILL OCCUR! 

Brain Bleeds on Steady Trend Upward

Study points to one patient subgroup

A head MRI showing deep intracerebral hemorrhage (cerebellum)
Intracerebral hemorrhage (ICH) has become increasingly common in recent decades, driven by events in older people, according to an analysis of the Framingham Heart Study.
The incidence of ICH increased steadily from 25 cases per 100,000 person-years in 1948-1986 (period 1) to 73 cases per 100,000 person-years in 2000-2016 (period 3), reported a team led by Vasileios-Arsenios Lioutas, MD, of Beth Israel Deaconess Medical Center and Harvard Medical School.
Altogether, people 75 years and older had ICH reach 176 cases per 100,000 person-years in 2000-2016 (up from 88 per 100,000 in 1948-1986) in the study published online in JAMA Neurology.
Importantly, the incidence trend differed depending on age:
  • Remained low in the group ages 45-74 years (not exceeding 25 cases per 100,000 person-years over time)
  • Increased slightly in people ages 75-84 years (from 96 to 113 cases per 100,000 person-years between periods 1 and 3)
  • Jumped substantially in the group 85 years and older (from 39 to 287 cases per 100,000 person-years between periods 1 and 3)
This increase coincided with increased use of statins and anticoagulant medications, Lioutas and colleagues noted.
"These findings, in conjunction with the expected increase in life expectancy, suggest that the absolute number of individuals who experience an ICH event, particularly at an older age, will likely continue to increase despite improvements in primary and secondary preventive interventions. Such a trend has already been documented in other high-income countries," they concluded.
Adjusted for age, ICH incidence showed an initial increase followed by a dip between 1987-1999 (51 cases per 100,000 person-years) and 2000-2016 (46 cases per 100,000 person-years), such that it was no higher during period 3 compared to period 1.
"This finding was likely associated with improvements in primary and secondary preventive practices, which is reflected in the well-documented decrease in the prevalence of risk factors in the Framingham Heart Study cohort; both hypertension prevalence and BP levels, which are the most important ICH risk factors, decreased steadily," according to Lioutas and team.
Their analysis drew upon 10,333 Framingham participants (originally enrolled in 1948) and their children. Of this cohort, 129 (55.8% women, age 77 on average) had an ICH over 68 years. After applying exclusion criteria, 99 ICH patients were matched 1:4 by age and sex to controls.
Overall, ICH risk was comparable between men and women. Both deep ICH and lobar ICH grew in incidence with advancing age.
Predictors of deep ICH were higher systolic and diastolic blood pressure and statin medication use. Factors associated with lobar ICH were higher systolic blood pressure and apolipoprotein E ε4 allele homozygosity.
The Framingham cohort was nearly all white, the authors cautioned, limiting the generalizability of the results to other populations. Another limitation of the study was that the investigators did not have data on antiplatelet use.
Last Updated June 09, 2020
  • author['full_name']
    Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow
Disclosures
The study was supported by grants from the National Institute of Neurological Disorders and Stroke; the National Institute on Aging; and the National Heart, Lung, and Blood Institute.
Lioutas disclosed receiving personal fees from Qmetis.

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