Sunday, April 18, 2021

Dynamics of cerebral perfusion and oxygenation parameters following endovascular treatment of acute ischemic stroke

But we still have NO PROTOCOL on how to deliver oxygen immediately post stroke to save neurons.

If your doctor is doing nothing about oxygen delivery to the brain s/he is letting more neurons die than should. ARE YOU OK WITH THAT?

I'm going to be demanding the following from my doctors but since I'm not medically trained you can't listen to me. But does your doctor have ANYTHING AT ALL? 

Possible solutions: Obviously not vetted coming from me. Don't do them.

You can look at the years these were reported on and tell how long your hospital has been incompetent.

 

How to Improve Your Brain Function with An Oxygen Concentrator April 2018 

Or is it more important to increase the loading ability of red blood cells to carry more oxygen? 

Like this?

University of Glasgow Study Demonstrates the Ability of Oxycyte® to Supply Oxygen to Critical Penumbral Tissue in Acute Ischemic Stroke  August 2012

Or like this?

chronic cannabis users have higher cerebral blood flow and extract more oxygen from brain blood flow than nonusers. August 2017   

Vinpocetine increases cerebral blood flow and oxygenation in stroke patients: a near infrared spectroscopy and transcranial Doppler study May 2015 

Or this? having red blood cells release more oxygen.

Methylene blue shows promise for improving short-term memory


HOW FUCKING LONG WILL YOU LET YOUR INCOMPETENT STROKE HOSPITAL STILL TREAT PATIENTS LIKE NOTHING NEW HAS OCCURRED IN THE PAST 50 YEARS?

The latest here:

 

Dynamics of cerebral perfusion and oxygenation parameters following endovascular treatment of acute ischemic stroke

  1. Gianluca Brugnara1,
  2. Christian Herweh1,
  3. Ulf Neuberger1,
  4. Mikkel Bo Hansen2,
  5. Christian Ulfert1,
  6. Mustafa Ahmed Mahmutoglu1,
  7. Martha Foltyn1,
  8. Simon Nagel3,
  9. Silvia Schönenberger3,
  10. Sabine Heiland1,
  11. Peter Arthur Ringleb3,
  12. Martin Bendszus1,
  13. Markus Möhlenbruch1,
  14. Johannes Alex Rolf Pfaff1,
  15. Philipp Vollmuth1
  1. Correspondence to Dr Philipp Vollmuth, Department of Neuroradiology, University Hospital Heidelberg, Heidelberg 69120, Baden-Württemberg, Germany; philipp.vollmuth@med.uni-heidelberg.de

Abstract

Background We studied the effects of endovascular treatment (EVT) and the impact of the extent of recanalization on cerebral perfusion and oxygenation parameters in patients with acute ischemic stroke (AIS) and large vessel occlusion (LVO).

Methods Forty-seven patients with anterior LVO underwent computed tomography perfusion (CTP) before and immediately after EVT. The entire ischemic region (Tmax >6 s) was segmented before intervention, and tissue perfusion (time-to-maximum (Tmax), time-to-peak (TTP), mean transit time (MTT), cerebral blood volume (CBV), cerebral blood flow (CBF)) and oxygenation (coefficientof variation (COV), capillary transit time heterogeneity (CTH), metabolic rate of oxygen (CMRO2), oxygen extraction fraction (OEF)) parameters were quantified from the segmented area at baseline and the corresponding area immediately after intervention, as well as within the ischemic core and penumbra. The impact of the extent of recanalization (modified Treatment in Cerebral Infarction (mTICI)) on CTP parameters was assessed with the Wilcoxon test and Pearson’s correlation coefficients.

Results The Tmax, MTT, OEF and CTH values immediately after EVT were lower in patients with complete (as compared with incomplete) recanalization, whereas CBF and COV values were higher (P<0.05) and no differences were found in other parameters. The ischemic penumbra immediately after EVT was lower in patients with complete recanalization as compared with those with incomplete recanalization (P=0.002), whereas no difference was found for the ischemic core (P=0.12). Specifically, higher mTICI scores were associated with a greater reduction of ischemic penumbra volumes (R²=−0.48 (95% CI –0.67 to –0.22), P=0.001) but not of ischemic core volumes (P=0.098).

Conclusions Our study demonstrates that the ischemic penumbra is the key target of successful EVT in patients with AIS and largely determines its efficacy on a tissue level. Furthermore, we confirm the validity of the mTICI score as a surrogate parameter of interventional success on a tissue perfusion level.

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