Microstroke Recovery Restores Blood Flow Before Brain Tissue

What this means is that there are NEVER strokes too good/small to treat. So your doctor has a lot of research to get accomplished to see what interventions are needed to recover from this problem.  COVID-19 has this problem on a massive scale, thrombi all over the place.

Your action point on this is to make damn sure you have all the classic symptoms, lost sensation, slurred speech, lack of movement on one side, dropped mouth. You don't want to be classified as too good to treat.

Every single stroke coming into your stroke hospital should have a protocol to follow. There is never a stroke that is too good to treat. You never magically recover from a stroke. Your doctor should never have to make a subjective decision. You have an objective damage diagnosis(The NIH Stroke Scale is not objective so we have a problem right from the start.). What should follow directly from that is a stroke protocol to remove the clot or stop the bleeding and then a protocol to stop the neuronal cascade of death or the hemorrhage cascade of death.  This is so fucking simple, why can't it be done?  Laziness? Incompetence? Or just don't care? No leadership? No strategy? Not my job?

 

Study: Even the smallest stroke can damage brain tissue, impair cognitive function

December 2012

Microstroke Recovery Restores Blood Flow Before Brain Tissue

Increased blood flow to the brain after a microscopic stroke doesn’t mean that part of the brain has recovered. At least not yet.
A study in Science Advances by Rice University neuroengineer Lan Luan and her colleagues used advanced neural monitoring technology to discover a significant disconnect between how long it takes blood flow and brain function to recover in the region of a microinfarct, a tiny stroke in tissue less than 1 millimeter in size.

The study led by Luan, a core faculty member of Rice’s Neuroengineering Initiative, shows “a pronounced neurovascular dissociation that occurs immediately after small-scale strokes, becomes the most severe a few days after, lasts into chronic periods and varies with the level of ischemia,” the researchers wrote.

The study in rodent models revealed the restoration of blood flow in the brain occurs first, followed by restoration of neuronal electrical activity. They observed that neuronal recovery could take weeks even for small strokes, and possibly longer for larger strokes.

The study required implants and instrumentation designed to monitor both blood flow and brain activity simultaneously before, during and after the onset of strokes.

“This started with the device,” said Luan, an assistant professor of electrical and computer engineering at Rice’s Brown School of Engineering, who developed a flexible neural electrode with co-author Chong Xie while both were at the University of Texas at Austin. “That was my transition from being trained as a material physicist to neuroengineering.

“As soon as we had the electrodes, I wanted to use them to understand brain functions and dysfunctions in a domain that was difficult to probe with previous technology,” she said. “The electrodes are extremely flexible and well suited to be combined with optical imaging in exactly the same brain regions.”

The electrodes were combined with optical lines able to measure blood flow by recording laser speckle patterns. The combined data, gathered for as long as eight weeks, gave the researchers an accurate comparison between blood flow and electrical activity.

“The strokes we focus on are so small that when they happen, it’s very hard to detect them from behavioral measures,” Luan said. “We would not easily see impairment in animal locomotion, meaning the animal could walk away just fine, from a lay perspective.

“The implications in humans are similar,” she said. “These microinfarcts can occur spontaneously, especially in aged populations. Because they’re so tiny, it’s not like you’re having a stroke. You will not notice it at all. But it has been long hypothesized that it’s related to vascular dementia.”

Luan said the neurological impact of individual microinfarcts is largely unknown. “That’s what motivated us to set up a series of experiments to really directly measure the impacts of those extremely small-scale injuries,” she said.

While the study would be hard to replicate in humans, the implications could improve diagnoses of patients who suffer microinfarcts.

“There are a lot of similarities in neurovascular coupling in rodent models and in humans,” she said. “What we observed in rodents likely has a similar signature in humans, and I hope that can be of use to clinicians.”

Luan said she is continuing her research at Rice, supported by a five-year R01 grant from the National Institute of Neurological Disorders and Stroke.

“We’re interested in knowing not just how a single microinfarct would alter neural activity but also, cumulatively, whether the effect of multiple microinfarcts that occur at different times would be stronger or weaker than the sum of the individuals,” she said.

Reference
He et al. (2020). Multimodal mapping of neural activity and cerebral blood flow reveals long-lasting neurovascular dissociations after small-scale strokes. Science Advances. DOI: https://doi.org/10.1126/sciadv.aba1933

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