WHOM is going to create protocols based on all this earlier research? SPECIFIC NAMES ONLY, none of this general crapola of followup should occur. If your doctor and stroke hospital can't provide a specific name, THEY NEED TO BE FIRED. I take no prisoners in trying to solve stroke, that means your doctors and PhDers need to do their job. 100% stroke recovery for all. NO EXCUSES.
Did your stroke hospital do ANYTHING AT ALL with this earlier research? Or were they incompetent like usual?
Our laboratory has now shown that substance P is released during stroke. And blocking substance P receptors following stroke subsequently reduces brain swelling and improves outcome and survival in rats May 2012
Radically New Patented Technology Highly Effective In Reducing Cerebral Oedema May 2012
Discovery paves way for treatments to prevent brain damage or death following head trauma April 2015
Innovative treatment may help prevent brain swelling, death in stroke patients April 2016
New biodegradable pressure sensor could help monitor serious health conditions
January 2018
Injected Nanoparticles May Provide First Real Treatment for Traumatic Brain Injury January 2020
Because our incompetent stroke medical 'professionals' still haven't figured out an EXACT BLOOD PRESSURE MANAGEMENT PROTOCOL post stroke! And YOU bear the failure of that! Hope your competent? doctor guesses correctly because the poor outcome happens to you! Your doctor gets off scot-free and still gets paid! My non-medical thinking on this is that by doing this you are vastly lowering the oxygen supply to the brain thus hastening the neuronal cascade of death!
blood pressure management (90 posts to June 2017)
The latest here, once again describing a problem but PROVIDING NO SOLUTION! How incompetent can you be and still employed in stroke?
Effects of Intensive Blood Pressure Lowering on Brain Swelling in Thrombolyzed Acute Ischemic Stroke: The ENCHANTED Results
Abstract
BACKGROUND:
Cerebral
swelling in relation to cytotoxic edema is a predictor of poor outcome
in acute ischemic stroke (AIS) and elevated blood pressure (BP) promotes
its development. Whether intensive BP-lowering treatment reduces
cerebral swelling is uncertain. We aimed to determine whether intensive
BP lowering reduces the severity of cerebral swelling after thrombolysis
for AIS.
METHODS:
A
secondary analysis of the ENCHANTED (Enhanced Control of Hypertension
and Thrombolysis Stroke Study), a partial factorial, international,
multicenter, open-label, blinded end point, randomized controlled trial
of alteplase dose and levels of BP control in thrombolyzed patients with
AIS. Participants were randomly assigned to intensive (systolic target
130–140 mm Hg within 1 hour; maintained for 72 hours) or
guideline-recommended (systolic target <180 mm Hg) BP management.
Available serial brain images (baseline and follow-up, computed
tomography, or magnetic resonance imaging) were centrally analyzed with
standardized techniques (Apollo MIStar software) by expert readers blind
to clinical details to rate swelling severity (from 0 no to 6 most
severe swelling [midline shift and effacement of basal cisterns]) and
other abnormalities. Primary outcome was any cerebral swelling (score,
1–6) in logistic regression models.
RESULTS:
Of
1477/2196 (67.3%) patients (mean age, 67.7 years; female, 39.6%) with
sequential scans, the between-group mean systolic BP difference was 6.6
mm Hg over 24 hours. No significant difference was found in the
treatment effect on any cerebral swelling between intensive and
guideline-recommended BP management (22.12% versus 22.39%, adjusted odds
ratio, 1.05 [95% CI, 0.81–1.36]; P=0.71). Results were
consistent across different groups of swelling severity (swelling score
2–6, 3–6, and 4–6; and ordinal shift on swelling score).
CONCLUSIONS:
Modest
early intensive BP lowering does not seem to alter cerebral swelling in
thrombolyzed patients with AIS. Further research is needed to quantify
brain edema to allow a better understanding of the complex relations of
BP and outcomes from AIS.
Graphical Abstract
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