Deans' stroke musings: Clinical Features, Risk Factors, and Early Prognosis for Wallerian Degeneration in the Descending Pyramidal Tract after Acute Cerebral Infarction

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.

Sunday, November 29, 2020

Clinical Features, Risk Factors, and Early Prognosis for Wallerian Degeneration in the Descending Pyramidal Tract after Acute Cerebral Infarction

Useless, NOTHING ON HOW TO PREVENT THIS.

Clinical Features, Risk Factors, and Early Prognosis for Wallerian Degeneration in the Descending Pyramidal Tract after Acute Cerebral Infarction

Published:November 27, 2020DOI:https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105480

Abstract

Background

Wallerian degeneration(WD) occurs in the descending pyramidal tract(DPT) after cerebral infarction commonly, but studies of its degree evaluation, influencing factors and effects on nervous function are still limited.

Objectives

The purpose of this study was to describe these findings and estimate their clinical significance.

Methods

In total, 133 patients confirmed acute cerebral infarction and restricted diffusion in the DPT of the cerebral peduncle by MRI scans. These cases were retrospectively reviewed. We describe their clinical characteristics and analyze influence factors of WD, including the timespan from symptom onset to MRI and TOAST classification. Their NIHSS scores at admission and first 7 days NIHSS improvement rate after admission were also analyzed.

Results

These patients were divided into three groups by timespan ≤7 days( n = 45),7–14 days( n = 70) and >14 days( n = 18). The mean WD degree (%)of these three groups was 44.41 ± 22.51,52.35 ± 22.61and 44.31 ± 19.35,respectively( p = 0.122).According to the TOAST classification, the mean WD degree(%) of the cardioembolism group( n = 28, 62.80 ± 25.12) was significantly different from both the large-artery atherosclerosis group( n = 73,45.08 ± 20.03, p = 0.000) and the small-vessel occlusion group( n = 23,39.68 ± 16.95, p = 0.000). The mean NIHSS score upon admission of the WD degree≤50% group( n = 82,8.17 ± 5.87) was different from that of the >50% group( n = 51,11.31 ± 7.00)( p = 0.006). However, the mean 7 days NIHSS improvement rate(%) of the WD degree≤50% group( n = 79,11.83 ± 23.76)and >50% group( n = 50,13.40 ± 27.88) was not significantly different( p = 0.733).

Conclusions

Early WD in ischemic stroke patients has a correlation with serious baseline functional defects. Therefore, we should give close attention to imaging change, especially in those with cardioembolism .