You'll have to ask your doctor what protocol they are using to prevent this problem from the cascade of death. Since they likely have no protocols ask what researchers they are working with to solve this problem. No researcher contact, call the stroke hospital president and ask why incompetency is allowed in their hospital. Delayed cerebral ischemia is too milquetoast a term to suggest immediate critical response needed, the hemorrhage cascade of death should be used since it implies extreme urgency.
Spreading depolarization A mysterious and deadly mediator of acute brain injury
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Studies
in subarachnoid hemorrhage (SAH) have traditionally focused on delayed
secondary ischemic injury due to vasospasm, but more recently, attention
has turned to early brain injury (EBI) in patients with poor-grade
injury. The predictable and delayed nature of secondary brain injury
makes SAH a unique illness. Large vessel arterial vasospasm occurs in
approximately 70% of patients starting 3 to 5 days after the initial
hemorrhage, peaking at 5 to 10 days, then slowly resolving over the
following week or two.1 Delayed cerebral ischemia (DCI),
defined as infarction, neurologic deterioration, or both from large
vessel vasospasm occurs in about 20% of patients with SAH. Interventions
and clinical investigation have long focused on DCI. Large trials have
failed to improve long-term neurologic outcome despite ameliorating
vasospasm.2 This has led to novel concepts of DCI
pathophysiology, including microthrombosis, neuroinflammation, and
cortical spreading depolarization (SD).1
- © 2018 American Academy of Neurology
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