Our stroke medical professionals seem to be blind to the fact that everything in stroke is a failure.
From reading everything on the ASA, NSA and WSO websites you would think everything is peachy keen in stroke. Ask why they are lying by omission.
0. There is no fast, easy and objective way to diagnose a stroke.
1. tPA may save your life with tPA having a 88% failure rate for full recovery.
2. Your neurologist doesn't have any concrete stroke protocols to save all the neurons that are dying in the first week.
3. Your neurologist or physiatrist doesn't have any clue about how to get you to full recovery. (Ask them exactly how to do it), you'll get excuses.
4. Only 10% get to full recovery..
5. No protocols to prevent your 33% dementia chance post-stroke from an Australian study.
6. Nothing to alleviate your fatigue.
7. Nothing that will cure your spasticity.
8. Nothing on cognitive training unless you find this yourself.
9. No published stroke protocols.
10. No way to compare your stroke hospital results vs. other stroke hospitals.
11. No damage diagnosis so our therapists know exactly what problems need to be solved.
Showing posts with label peachy keen. Show all posts
Showing posts with label peachy keen. Show all posts
Thursday, May 7, 2015
Wednesday, May 6, 2015
Acute Stroke Intervention - A Systematic Review
I hate these types of articles, from reading this you would think progress is being made. Rather that they still don't discuss 30-day deaths or the neuronal cascade of death and how to lower that.
And no mention of the pathetic 12% efficacy of tPA.
Everything must be peachy keen in the stroke world then.
http://jama.jamanetwork.com/article.aspx?articleID=2247149
And no mention of the pathetic 12% efficacy of tPA.
Everything must be peachy keen in the stroke world then.
http://jama.jamanetwork.com/article.aspx?articleID=2247149
ABSTRACT
Importance
Acute ischemic stroke is a major cause of mortality and
morbidity in the United States. We review the latest data and evidence
supporting catheter-directed treatment for proximal artery occlusion as
an adjunct to intravenous thrombolysis in patients with acute stroke.
Objective To review the pathophysiology of acute brain ischemia and infarction and the evidence supporting various stroke reperfusion treatments.
Evidence Review Systematic literature search of MEDLINE databases published between January 1, 1990, and February 11, 2015, was performed to identify studies addressing the role of thrombolysis and mechanical thrombectomy in acute stroke management. Studies included randomized clinical trials, observational studies, guideline statements, and review articles. Sixty-eight articles (N = 108 082 patients) were selected for review.
Findings Intravenous thrombolysis is the mainstay of acute ischemic stroke management for any patient with disabling deficits presenting within 4.5 hours from symptom onset. Randomized trials have demonstrated that more patients return to having good function (defined by being independent and having slight disability or less) when treated within 4.5 hours after symptom onset with intravenous recombinant tissue plasminogen activator (IV rtPA) therapy. Mechanical thrombectomy in select patients with acute ischemic stroke and proximal artery occlusions has demonstrated substantial rates of partial or complete arterial recanalization and improved outcomes compared with IV rtPA or best medical treatment alone in multiple randomized clinical trials. Regardless of mode of reperfusion, earlier reperfusion is associated with better clinical outcomes.
Conclusions and Relevance Intravenous rtPA remains the standard of care for patients with moderate to severe neurological deficits who present within 4.5 hours of symptom onset. Outcomes for some patients with acute ischemic stroke and moderate to severe neurological deficits due to proximal artery occlusion are improved with endovascular reperfusion therapy. Efforts to hasten reperfusion therapy, regardless of the mode, should be undertaken within organized stroke systems of care.
Objective To review the pathophysiology of acute brain ischemia and infarction and the evidence supporting various stroke reperfusion treatments.
Evidence Review Systematic literature search of MEDLINE databases published between January 1, 1990, and February 11, 2015, was performed to identify studies addressing the role of thrombolysis and mechanical thrombectomy in acute stroke management. Studies included randomized clinical trials, observational studies, guideline statements, and review articles. Sixty-eight articles (N = 108 082 patients) were selected for review.
Findings Intravenous thrombolysis is the mainstay of acute ischemic stroke management for any patient with disabling deficits presenting within 4.5 hours from symptom onset. Randomized trials have demonstrated that more patients return to having good function (defined by being independent and having slight disability or less) when treated within 4.5 hours after symptom onset with intravenous recombinant tissue plasminogen activator (IV rtPA) therapy. Mechanical thrombectomy in select patients with acute ischemic stroke and proximal artery occlusions has demonstrated substantial rates of partial or complete arterial recanalization and improved outcomes compared with IV rtPA or best medical treatment alone in multiple randomized clinical trials. Regardless of mode of reperfusion, earlier reperfusion is associated with better clinical outcomes.
Conclusions and Relevance Intravenous rtPA remains the standard of care for patients with moderate to severe neurological deficits who present within 4.5 hours of symptom onset. Outcomes for some patients with acute ischemic stroke and moderate to severe neurological deficits due to proximal artery occlusion are improved with endovascular reperfusion therapy. Efforts to hasten reperfusion therapy, regardless of the mode, should be undertaken within organized stroke systems of care.
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