Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 34,358 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke. DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
Changing stroke rehab and research worldwide now.Time is Brain!trillions and trillions of neuronsthatDIEeach day because there areNOeffective 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.
What the hell are YOU doing to stop this problem? NOTHING? Then get the hospital reconstituted with some competent stroke rehab persons!
What is your competent? doctors EXACT PROTOCOL to prevent post-stroke epilepsy and seizures? And they have been working on this for over a decade, right?
The incidence of in-hospital seizures and status epilepticus following mechanical thrombectomy for acute ischemic stroke has risen significantly, with specific vascular territories and patient comorbidities driving the increased risk.
The rate of in-hospital seizures after mechanical thrombectomy has increased over time, according to study results published in Neurology Open Access.
Mechanical thrombectomy is a cornerstone therapy for acute ischemic stroke caused by large vessel occlusion (LVO), particularly after its endorsement by the American Heart Association/American Stroke Association in 2015. Patients undergoing mechanical thrombectomy typically present with severe LVO strokes involving extensive vascular territories and frequent cortical involvement. These are both established risk factors for seizures.
Researchers analyzed data from the National Inpatient Sample from 2016 to 2022 to evaluate in-hospital seizures among adults hospitalized with ischemic stroke who underwent mechanical thrombectomy. The analysis included 632,485 patients.
Overall, 1.88% of patients (n=11,903) had a seizure diagnosis recorded during the index hospitalization. The rate of seizures increased from 1.60% in 2016 to 2.34% in 2022. Rates of both status epilepticus and nonstatus seizures increased during the study period, from 0.079% to 0.206% and from 1.52% to 2.13%, respectively.
Several independent risk factors identified in this study are common and potentially modifiable early in the stroke course, highlighting opportunities for targeted metabolic and medical optimization.
Patients with status epilepticus had longer hospital stays than patients with nonstatus seizures and those without seizures (mean, 17.32 vs 7.86 vs 5.03 days, respectively; P <.001). They also had higher mean hospital charges ($371,485.72 vs $164,213.88 vs $119,561.20, respectively; P <.001) and in-hospital mortality (25% vs 6.7% vs 4.6%, respectively; P <.001).
In multivariable analyses of vascular territory and thrombectomy location, seizure risk was associated with intracranial artery thrombectomy (odds ratio [OR], 1.39; P =.016), left internal carotid artery thrombectomy (OR, 1.39; P =.014), right internal carotid artery thrombectomy (OR, 1.35; P =.026), right vertebral artery thrombectomy (OR, 2.46; P =.003), and left vertebral artery thrombectomy (OR, 2.06; P =.016). Among patients with status epilepticus, only left vertebral artery thrombectomy remained independently associated with risk (OR, 5.65; P =.002). Right anterior cerebral artery stroke was also associated with increased seizure risk (OR, 2.40; P =.002).
Comorbidities independently associated with seizure risk included the following:
Psychoses (OR, 2.88; P <.001);
Depression (OR, 1.65; P <.001);
Lymphoma (OR, 1.80; P =.044);
Fluid and electrolyte disorders (OR, 1.43; P <.001);
Alcohol abuse (OR, 1.40; P =.001);
Chronic pulmonary disease (OR, 1.30; P <.001); and,
Complicated diabetes (OR, 1.15; P =.030)
Obesity was associated with lower seizure risk (OR, 0.84; P =.011). Among patients with status epilepticus, significant associations included fluid and electrolyte disorders (OR, 2.20; P <.001), uncomplicated hypertension (OR, 1.97; P =.013), complicated diabetes (OR, 1.65; P =.016), coagulopathy (OR, 1.63; P =.038), and brain herniation (OR, 2.18; P =.002).
Study limitations include the lack of detailed procedural and stroke-severity data and the inability to determine whether seizures were procedure-related. Also, seizure diagnoses were based on in-hospital coding, preventing assessment of seizure timing or postdischarge recurrence.
The study authors concluded, “Several independent risk factors identified in this study are common and potentially modifiable early in the stroke course, highlighting opportunities for targeted metabolic and medical optimization.”
Cite this article as: Tamiya F, Tateishi T, Shimoda S, et al. (October 08, 2026) Proposal for a Robot Rehabilitation Strategy Tailored to the Recovery Stage of Gait Impairment After Subacute Stroke: A Preliminary Case Report. Cureus 18(10): e117654. doi:10.7759/cureus.117654
Abstract
Robot-assisted gait training (RAGT) has been increasingly applied as an intervention method for stroke hemiplegia patients' abnormal gait patterns. We describe an intervention strategy that attempts the precise adjustment of tasks' difficulty according to the severity of gait impairment by progressively adapting two types of robots in accordance with the subject's recovery process. This case report describes a 53-year-old man who presented with left hemiplegia due to a right lacunar infarction. He was admitted to our rehabilitation hospital 14 days after stroke onset and underwent a staged gait-training program from days 14 to 77 after stroke onset, including treadmill-driven RAGT from days 16 to 28 and orthosis-mounted RAGT from days 55 to 69. At his initial assessment, the patient required assistance with walking due to moderate motor paralysis. In the early stages of intervention, a treadmill-driven robot was introduced(Why not the split-belt treadmill?) with the goal of improving the patient's walking independence. Subsequently, after supervised walking had been achieved and residual gait abnormalities persisted during conventional gait training, the patient transitioned to flat-ground walking practice using an orthosis-mounted robot with the goal of optimizing walking patterns. The sequential intervention was associated with improvement in walking independence, with the Functional Ambulation Category increasing from 1 to 5 by discharge, and improvements in stiff-knee gait and toe clearance were also observed. These findings suggest that stage-specific selection of robotic devices according to therapeutic goals may be a feasible approach for addressing both walking independence and residual gait abnormalities after stroke.
Useless generalities! Survivors want EXACT 100% RECOVERY PROTOCOLS, you blithering idiots! And Steven Cramer is a rock star stroke researcher. Sorry about the dis, Dr. Cramer but you will want 100% recovery when you are the 1 in 4 per WHO that has a stroke and if I have to insult you to get you working on that, so be it! Contact me at oc1dean@gmail.com and we can discuss how to get there. But off to Japan and South Africa so mostly incommunicado for the next couple months. Looking forward to our discussions in person.
Subjective social status (SSS) represents self-perceived social position and may affect poststroke recovery. Despite impacting various medical outcomes, SSS remains understudied in stroke. We hypothesized that higher SSS is associated with better stroke recovery at 3- and 12 months poststroke.
METHODS:
In this prospective cohort study, patients were enrolled between October 2016 and February 2020. We examined associations between 3-month SSS score and clinician-reported, performance, and patient-reported outcomes at 3- and 12-month assessments. Ordinal multivariable regression analysis evaluated 3-month SSS score as a predictor of 12-month modified Rankin Scale score.
RESULTS:
The 494 participants had a median age of 63.5 years; 200 (41%) were female, and median (interquartile range) acute National Institutes of Health Stroke Scale score was 4 (2–8). Scores on SSS showed no meaningful associations with performance outcomes and some associations with clinician-reported outcomes (eg, 3-month modified Rankin Scale: ρ, −0.12 [95% CI, −0.21 to −0.03], false discovery rate-adjusted P=0.017; 12-month modified Rankin Scale: ρ12mo, −0.18 [95% CI, −0.27 to −0.09], false discovery rate-adjusted P=0.001). Conversely, higher SSS showed strong, consistent correlations with patient-reported outcomes, including less psychological distress and higher Stroke Impact Scale-Activities of Daily Living (ρ3mo, 0.18 [95% CI, 0.09–0.26]; ρ12mo, 0.17 [95% CI, 0.07–0.26]; all false discovery rate-adjusted P<0.05). Item-level analyses of Stroke Impact Scale-Activities of Daily Living revealed that SSS remained most strongly and consistently linked to complex Stroke Impact Scale-Activities of Daily Living motor tasks over time. In ordinal multivariable regression adjusted for age, sex, stroke subtype, initial severity, and the selected objective socioeconomic status proxies (eg, educational attainment, employment, and marital status), 3-month SSS score significantly predicted 12-month modified Rankin Scale score (β, 0.14 [95% CI, 0.02–0.26]; P=0.014).
CONCLUSIONS:
In patients with predominantly mild stroke, 3-month SSS score may serve as a significant social determinant of health that is associated with long-term functional recovery, a relationship closely linked with psychological distress. SSS scores at 3 months poststroke may identify vulnerable patients, enabling development, validation, and targeted application of interventions that optimize stroke recovery.
You delivered NOTHING that gets survivors recovered! 'Care' doesn't deliver recovery you blithering idiots! There is NO leadership anywhere in stroke. How many funerals need to occur before we get great stroke leadership?
"From Resolution to Action: Investing in Acute Stroke Care" took place during United Nations General Assembly week. The meeting focused on translating global commitments on stroke into concrete improvements in prevention, acute treatment, rehabilitation and access to care(NOT RECOVERY!).
Oct. 8, 2026 — Government officials, global health leaders, clinicians, patient advocates, professional societies and industry partners gathered during United Nations General Assembly week for "From Resolution to Action: Investing in Acute Stroke care(NOT RECOVERY!)," a convening focused on translating global commitments on stroke into concrete improvements in prevention, acute treatment, rehabilitation and access to care(NOT RECOVERY!). The September 22 reception was convened through the Society of Vascular and Interventional Neurology's (SVIN) Mission Thrombectomy in partnership with the Business Council for International Understanding (BCIU), Philips and Medtronic Neurovascular.
Photo: Society of Vascular and Interventional Neurology
The event brought together representatives from leading international cardiovascular, stroke, neurointerventional and global neurosurgical organizations, including the American Heart Association (AHA), World Stroke Organization (WSO), World Federation of Interventional and Therapeutic Neuroradiology (WFITN), Society of NeuroInterventional Surgery (SNIS), and International Society for Global Neurosurgery (ISGNS), alongside Ministries of Health and other global health stakeholders. Together, they brought perspectives spanning public health, stroke systems, neurointervention, global neurosurgery, policy, and implementation.
From Resolution to Action
The gathering came at a pivotal moment for global stroke policy. WHA79.10, adopted by the World Health Assembly in May, represents a landmark global commitment to addressing stroke comprehensively, including prevention, acute care(NOT RECOVERY!), rehabilitation, and health-system readiness.
Importantly, WHA79.10 was championed by the Egyptian Ministry of Health and Population, with support from the Global Stroke Action Coalition (GSAC), a coalition comprising global organizations and industry leaders dedicated to advancing stroke prevention, treatment, rehabilitation, and access to care(NOT RECOVERY!) worldwide. The resolution represents an important example of how governments, professional organizations, patient advocates, and industry can work together to elevate stroke on the global health agenda.
The discussion centered on a fundamental challenge: scientific advances have made highly effective stroke treatments possible, including mechanical thrombectomy for large-vessel occlusion, but millions of eligible patients worldwide still cannot access these treatments in time.
Strokenomics: Investing in Recovery
Dr. Fawaz Al-Mufti, Global Chair, SVIN-Mission Thrombectomy, opened the clinical discussion with "The Clinical and Economic Case for Acute Stroke Treatment," highlighting the extraordinary effectiveness of mechanical thrombectomy for eligible patients with large-vessel occlusion stroke.
Drawing on global data and an economic analysis spanning six countries, Al-Mufti emphasized that investing in access to thrombectomy can represent a fraction of the societal cost associated with stroke-related disability.
"We are already paying for stroke," said Al-Mufti. "The question is whether we choose to pay for recovery today or disability for years to come. A timely thrombectomy can offset a lifetime of disability and its associated costs. We need to stop viewing thrombectomy simply as a procedural expense and recognize access to effective stroke treatment as an investment in people, families and national capacity."
A Riveting Stroke Story of Resilience
The patient perspective was brought into sharp focus by Margaret O'Neil Wheeler, who shared a moving account of resilience and fortitude following a large-vessel-occlusion stroke. Accompanied by her husband, whose prompt recognition and action helped get her to life-saving care(NOT RECOVERY!) in time, Wheeler was reunited at the event with Dr. Fawaz Al-Mufti, who performed her emergency mechanical thrombectomy at Westchester Medical Center. Their reunion put a human face on the numbers, offering a powerful reminder of what timely access to advanced stroke care(NOT RECOVERY!) can mean: not simply survival, but recovery, independence, and the opportunity to return to life after stroke.
From Global Advocacy to Global Access
Dr. Dileep Yavagal, Founder and Global Chair Emeritus, SVIN-Mission Thrombectomy, followed with "From Global Advocacy to Global Action."
Yavagal described stroke as a "long neglected pandemic" and emphasized that solving the global access gap requires more than simply building additional thrombectomy centers. Sustainable systems require public and pre-hospital education, government advocacy, technology, financing, trained teams, and implementation strategies tailored to individual countries.
"We have crossed the scientific frontier - we know thrombectomy can profoundly alter the course of a devastating stroke," said Yavagal. "The frontier before us now is access."
Turning Recognition Into Action
The urgency expressed at the convening reflects a broader commitment from SVIN leadership to translate scientific progress and global policy recognition into measurable improvements in stroke care(NOT RECOVERY!) worldwide.
Santiago Ortega-Gutierrez, MD, President of the Society of Vascular and Interventional Neurology, framed this as a responsibility for SVIN and the broader stroke community:
"Stroke does not respect borders, and access to life-saving treatment should not be determined by where a patient lives. The science is clear, the therapies exist, and the global community has recognized stroke as an urgent health priority. Our responsibility now is to turn that recognition into action. Through Mission Thrombectomy, SVIN is committed to measurable progress in access, treatment, and recovery—with the goal that every eligible patient has a meaningful opportunity to survive stroke without preventable disability."
Kaiz Asif, MD, Vice Chair of SVIN–Mission Thrombectomy, focused on the ultimate measure of that progress: whether treatment reaches patients:
"Recognition is important, but ultimately our success will be measured by access. Our goal is to translate this global momentum into a simple reality: that more patients, regardless of where they live, can reach life-saving thrombectomy in time."
Robin Novakovic-White, MD, President-Elect of the Society of Vascular and Interventional Neurology, emphasized the collaboration required to translate scientific advances into equitable access:
"The science has given us the ability to dramatically change the outcome of a devastating stroke. The next challenge is ensuring that this opportunity is not defined by geography or resources. That will require sustained collaboration among clinicians, health systems, governments, and communities to translate what we know into meaningful access for patients worldwide."
Building Systems
Industry partners underscored that innovation must be accompanied by the systems required to deliver treatment.
"Innovation alone is not enough. Devices and therapies make a meaningful difference only when patients can reach the right facility, receive timely diagnosis, and be treated by trained teams within an integrated system of care(NOT RECOVERY!)," said Signe Haughton, Senior Director of Medical, Government, & Societal Affairs and Chief of Staff at Medtronic Neurovascular
Philips emphasized the role of connected technologies and workflows:
"For people experiencing stroke, every minute matters. Better-connected data, technologies, and clinical workflows can help healthcare professionals make timely decisions, support rapid diagnosis and appropriate treatment, and expand access to the right care(NOT RECOVERY!) when patients need it most," said Felipe Basso, Chief Executive Officer, Latin America, Philips.
What Implementation Can Look Like
Dr. Mohamed Fawzi, Radiology Advisor to the Minister of Health and Population, Ministry of Health and Population, Arab Republic of Egypt, provided a country perspective on building a national stroke system.
Egypt's progress includes 206 stroke units and centers, 58 certified through GAHAR, free thrombolysis, reimbursement for thrombectomy, approval of tenecteplase, and a prehospital hotline linking approximately 100 hospitals. A national electronic stroke registry is also being launched, with plans to expand the network to 440 units, strengthen certification, establish a national rehabilitation pathway, and publish national treatment rates and treatment times.
The message emerging from the convening was clear: a resolution creates momentum; implementation is what changes outcomes for patients.
The science exists. The therapies exist. The opportunity now is to build the systems that ensure every eligible patient - regardless of geography or resources - can reach life-saving stroke treatment in time.
To learn more about the meeting, go to www.svin.org/
Vitor Mendes Pereira, MD, performs the first telerobotic procedure of its kind on a stroke patient 120 miles away. Fred Moll, chairman of XCath Robotics, looks on. Image courtesy of XCath Robotics.
XCath Robotics has received the FDA's breakthrough device designation for its Iris surgical robotic system that performs remote robotic-assisted mechanical thrombectomy in acute ischemic stroke patients.
This represents a significant step forward for the Houston-based medtech company. The FDA's breakthrough devices drogram helps support the development of medical devices that have the potential to provide more effective treatment for patients with life-threatening or irreversibly debilitating conditions. This provides XCath Robotics with more opportunities to interact with FDA experts and receive support as the company works toward U.S. regulatory approval for the Iris system.
Back in March, the Iris system was used to complete the world’s first telerobotic stroke thrombectomy. Neurosurgeon Vitor Mendes Pereira, MD, chair of advanced neurovascular interventions at the University of Toronto, used the system to perform the historic procedure in Santiago, Panama, while the patient was 120 miles away in Panama City.
XCath Robotics said the Iris technology could open the door to breaking down the geographic barriers to specialist stroke care. Mechanical thrombectomy is widely regarded as the gold standard treatment for patients suffering a large vessel occlusion (LVO) stroke, which is the deadliest and most disabling type of ischemic stroke. However, access to the procedure remains limited outside of major cities, both in the U.S. and internationally.
The global median rate of access to mechanical thrombectomy is only about 2.79%. LVO strokes, similar to heart attacks, have a limited window for treatment before irreversible damage is caused as brain tissues dies. About 77% of patients either die or are left with severe disability.
The U.S. government has recently shown interest in expanding access to robotic stroke thrombectomy. This includes funding through the Advanced Research Projects Agency for Health (ARPA-H) to accelerate the development of an autonomous, remote endovascular robotic system that perform mechanical thrombectomy on stroke patients. Siemens Healthineers was awarded $31.1 million to accelerate the development of an autonomous, remote endovascular robotic system that can perform thrombectomy on stroke patients. Philips Healthcare was also awarded $33.7 million to develop an autonomous robotic system with partners Johns Hopkins University, Boston University and Weill Cornell Medicine.
Meredith Hay, PhD (center), has been hard at work on this research for more than a decade now. Image courtesy of The University of Arizona.
Researchers with the University of Arizona College of Medicine – Tucson are hoping a small peptide born in a laboratory can be a game-changer for the treatment of patients presenting with vascular dementia.
There are currently no real treatments for vascular dementia other than making lifestyle changes. The group behind this research hopes they can change that forever.
“Patients are in desperate need of an effective treatment, and we are doing everything we can to help find that treatment,” Meredith Hay, PhD, a professor of physiology with the college and co-inventor of this peptide, said in a statement. “The greatest reward would be to see a safe and effective treatment for people who currently have very few options.”
Hay and her team have been examining the potential of this peptide , PNA5, for more than a decade at this point. When it enters the brain, it triggers chemical reactions that increase oxygenation(This would seem very important in stroke to try to save as many neurons as possible in the hyperacute stage! If your doctor doesn't even know about this; PURE INCOMPETENCE!) and decrease inflammation. PNA5 has already been shown to improve blood flow and target inflammation in a way that improves cognitive performance—now the goal is to see if this can help treat vascular dementia.
“Inflammation is part of the body's natural repair system,” Hay explained. “If you have an injury, inflammation helps the healing process. The problem occurs when inflammation does not switch off. In vascular dementia, the brain's resident immune signals can remain activated.”
Hay’s team is currently planning to kick off a new clinical trial funded by a $9 million grant from the National Institute on Aging. For this study, 60 healthy volunteers will receive injections of PNA5 at different doses to evaluate the peptide’s safety. If that trial is a success, additional research could be underway by late 2027.
After helping invent PNA5, Hay co-founded a startup, ProNeurogen, focused on the development and potential commercialization of the small peptide. In the same statement, she shared the satisfaction she has felt seeing PNA5 continue to gain more momentum in recent years.
“The most rewarding part is seeing a basic scientific observation move toward something that could eventually help patients and families—that's what gets me up every day," she said. "It's exciting, but also very humbling.”
We’re sharing this article early to provide faster access to peer-reviewed, accepted research. It is citable and carries a permanent DOI. This version is subject to further edits and will be replaced automatically by the final Version of Record. All legal disclaimers apply.
Abstract
Measurement of neurologic function is critical for diagnosis, prognosis, and clinical trials. Wearable inertial measurement units (IMUs) offer a compact and unobtrusive sensing method to capture spatio-temporal gait data in clinic and non-clinic environments. We used validated IMU-based algorithms to extract spatiotemporal and inertial gait features in 53 patients with Hereditary Spastic Paraplegia (HSP) (43 UHSP, 10 CHSP), drawn from a cohort of 69 enrolled subjects after excluding trials with incomplete or corrupted data. Classification models were trained to distinguish between uncomplicated (UHSP) and complicated (CHSP) diagnoses of HSP using two feature sets: i) a spatiotemporal (ST) feature set associated to stride length, width, duration, and speed, and ii) a spatiotemporal and inertial (STI) feature set associated with swing acceleration and angular velocity. STI features showed statistically significant differences between UHSP and CHSP patient cohorts and improved classification performance relative to classifiers trained with ST features alone: a linear support vector machine trained on STI features achieved 86.8% accuracy, 70.0% CHSP recall, and an AUC of 0.77 under leave-one-subject-out cross-validation, compared to 73.6% accuracy and an AUC of 0.65 for the same model trained on ST features only. These findings highlight the utility of wearable IMUs for detailed gait assessment and underscore the potential of STI features to capture gait impairment associated with HSP diagnostic subtype beyond what spatiotemporal metrics alone provide. Given the small, imbalanced complicated-HSP sample (n=10), these estimates carry wide confidence intervals and should be interpreted as preliminary. IMU-based approaches provide a scalable and portable tool for evaluating neurologic gait disorders that merits validation in larger cohorts.
