Angiogenesis and Microvascular Remodeling

 Your competent? doctor figured out how to create new blood vessels for neurogenesis and saving neurons in the penumbra a long time ago, right! Oh no, you DON'T have a functioning stroke doctor, do you?

angiogenesis (141 posts to April 2011)

Angiogenesis and Microvascular Remodeling

NeuroVoices: Mitch Elkind, MD, MS, FAHA, on Enhancing Brain Health Amid World Stroke Day

 NOTHING ON GETTING TO 100% RECOVERY! Everyone here needs to be fired!

The useless word 'care' is bandied about a lot, PROVING INCOMPETENCE!

NeuroVoices: Mitch Elkind, MD, MS, FAHA, on Enhancing Brain Health Amid World Stroke Day

The chief science officer at the American Heart Association discusses its priorities for stroke prevention, cross-specialty collaboration, and equitable care as clinicians mark World Stroke Day 2025.Mitch S.V. Elkind, MD, MS, FAHA 

Stroke remains a leading cause of death and disability worldwide, with incidence rising among younger adults as lifestyle-related risk factors grow more prevalent. World Stroke Day, observed each year on October 29, serves as a reminder of the critical need for prevention, rapid recognition, and equitable access to care(NOT RECOVERY!). Before this year’s observance,NeurologyLive® spoke with Mitch S.V. Elkind, MD, MS, FAHA, chief science officer for brain health and stroke at the American Heart Association (AHA), about the most urgent challenges in stroke prevention and long-term recovery. In this Q&A, Elkind highlighted the importance of cardiometabolic risk reduction, cross-specialty collaboration between neurologists and cardiologists, and improving public awareness through community-focused education and quality initiatives like the AHA’s Get With The Guidelines–Stroke program. NeurologyLive: For this year’s stroke awareness day, what do you see as the most urgent priorities in improving stroke prevention today, especially given the rising rates among younger adults? Mitch S. V. Elkind, MD, MS, FAHA:The rising rates of cardiometabolic diseases, like obesity and diabetes, and related conditions, like hypertension, are of greatest concern. About 40% of US adults are obese, and the American Heart Association projects that this will increase to about 60% by 2050 if current trends continue. Obesity brings on diabetes and high blood pressure, which are major risk factors for stroke. We can address this by encouraging people to learn and follow the American Heart Association’s simple checklist for healthy living, Life’s Essential 8 Life’s Essential 8 covers 4 health factors and 4 health behaviors. The 4 factors—about which the American Heart Association recommends you “know your numbers”—are blood pressure, cholesterol, blood sugar, and weight or body mass index. The 4 health behaviors are eating a healthy, Mediterranean-style diet; getting sufficient exercise (at least 150 minutes weekly of moderate to vigorous activity); getting enough sleep (7 hours nightly); and avoiding tobacco. Maintaining healthy numbers for Life’s Essential 8 is associated with reduced risk of stroke and dementia. How do cardiology and neurology intersect most effectively in stroke care(NOT RECOVERY!), and where are we still falling short? There are several places of intersection between cardiology and neurology when it comes to stroke care(NOT RECOVERY!). First, cardiologists can be very helpful in managing patients’ risk factors for stroke, such as blood pressure and diabetes. Second, once stroke occurs, cardiologists can help in the evaluation of the patient to determine why the stroke occurred; for example, they often perform and interpret ultrasound tests of the heart and tests to monitor the heart rhythm. These tests can help identify whether blood clots from the heart may be a cause of the stroke. Third, neurologists and cardiologists often work together to decide whether patients should undergo procedures on the heart or neck blood vessels to reduce the risk of future stroke. Relatively new procedures, such as closure of a patent foramen ovale—a connection between the right and left sides of the heart—with an umbrella-like device, can reduce the risk of recurrent stroke in young people for whom this was a likely cause. In older patients with atrial fibrillation, exclusion of the left atrial appendage with a different device can reduce the risk of another stroke. Finally, because patients with heart disease have a high risk of stroke compared with those without heart disease, neurologists can help cardiologists decide how best to reduce stroke risk in these patients—and be available when they do have strokes, for example, after cardiac procedures. 

Cardiologists and neurologists can work together even better by ensuring that their hospitals establish more formal ways for these specialists to collaborate, perhaps through the use of joint training sessions and case conferences. This would ensure that all members of the care(NOT RECOVERY!) team are aware of the latest developments and deliver a consistent message to patients, who may be unfamiliar with medical terminology and in a state of anxiety after their stroke. They can also work together to ensure that shared decision-making is used to enable patients to make better and more informed decisions about their care(NOT RECOVERY!). What lessons from cardiovascular medicine can neurologists apply to improve long-term stroke outcomes? An important part of cardiac care after heart attack or surgery is cardiac rehabilitation. Cardiac rehab involves helping patients increase activity levels and ensuring their risk factors are well controlled. It also includes maximizing cardiovascular fitness. It is a standard part of care(NOT RECOVERY!) covered by insurance for many months after care(NOT RECOVERY!). Stroke rehabilitation tends to focus on learning how to compensate for any deficits caused by the stroke, and helping one to reintegrate into home life as well as possible. This is essential. But stroke rehabilitation does not yet include the focus on cardiovascular fitness as a major factor in the way that cardiac rehab does, although research is ongoing in this area to demonstrate its value. This may result from the fact that many stroke patients are unable to use exercise equipment due to weakness, incoordination, sensory loss, and other deficits; the equipment can be modified, however, in ways that enable working on fitness as well as function. Enhanced cardiovascular fitness is important to prevent future strokes, other cardiovascular events, and cognitive decline.

World Stroke Day emphasizes equity. How can we close gaps in stroke recognition and treatment across diverse communities?

We can close gaps in recognition of care(NOT RECOVERY!) by providing education to all communities about stroke symptoms and warning signs. The FAST mnemonic is easy for people to remember and use in an emergency: FAST stands for F: face weakness; A: arm weakness or sensory loss; S: speech difficulty; and T: time to call 911. The Hip Hop Stroke program, for example, uses FAST to educate school-age children in Harlem and other communities using music and entertainment to capture their interest. In some instances, children who have learned from Hip Hop Stroke have saved the lives of family members and strangers who were having strokes and received timely treatment. The American Stroke Association recently introduced a Spanish-language version similar to FAST, called RÁPIDO, which covers the same symptoms and a couple of others.

Quality improvement programs like the American Heart Association's Get With The Guidelines–Stroke initiative have been very successful in improving the quality of stroke care(NOT RECOVERY!) for people from diverse socioeconomic backgrounds and in reducing the gaps in care(NOT RECOVERY!) among different communities. Get With The Guidelines includes stroke registries that capture data on how patients are treated in different hospitals, educational materials, outreach by trained staff to improve the quality of care(NOT RECOVERY!) given, and recognition of those centers that meet the highest standards of care(NOT RECOVERY!). Meeting these standards is essential to obtaining and maintaining certification as a primary or comprehensive stroke center.

Looking ahead, what message would you like to emphasize to clinicians and policy makers on this World Stroke Day about the future of stroke care(NOT RECOVERY!)?

We have made tremendous advances(I haven't seen anything useful come out since tPA was approved in 1996) in the treatment of acute stroke over the past decade, using clot-busting drugs, clot extraction devices, and advanced imaging. But treatment is still highly dependent on rapid recognition of stroke symptoms and bringing patients to the hospital immediately. We need to make sure that everyone, everywhere knows the signs and symptoms of stroke and the correct response; time is brain, and we should be sure that stroke care(NOT RECOVERY!) gets the same rapid attention as a heart attack.

Stroke can also happen to anyone at any age. We are seeing younger and younger people experience stroke. We need to do a better job of preventing stroke by reducing the burden of high blood pressure, obesity, and diabetes in society because the best treatment of stroke is not to have one in the first place.

Targeting the NLRP3-ROS Axis: Disrupting the Oxidative-Inflammatory Vicious Cycle in Intracerebral Hemorrhage

 Didn't your competent? doctor create a solution for this problem years ago? 

oxidative stress (8 posts to November 2013)

Targeting the NLRP3-ROS Axis: Disrupting the Oxidative-Inflammatory Vicious Cycle in Intracerebral Hemorrhage

Authors Cao L , Pi W, Zhang Y, Zheng C, Yong VW, Xue M

Received 22 March 2025

Accepted for publication 13 July 2025

Published 24 July 2025 Volume 2025:18 Pages 9849—9870

DOI https://doi.org/10.2147/JIR.S529884

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Adam Bachstetter

 Liang Cao Journal of Inflammation Research downloaded from https://www.dovepress.com/ For personal use only. 1,2, Wenjun Pi3, Yi Zhang4, Chunfu Zheng5, Voon Wee Yong6, Mengzhou Xue1,2

1 Department of Cerebrovascular Diseases, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 

 

2 Henan International Joint Laboratory of Intracerebral Hemorrhage and Brain Injury, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 

3 Department of Traumatic Orthopedics, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, People’s Republic of China; 

4 Office of Research, Shunyi Maternal and Children’s Hospital of Beijing Children’s Hospital, Beijing, People’s Republic of China; 

5 Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, Calgary, Alberta, Canada; 

6 Hotchkiss Brain Institute and Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada Correspondence: Voon Wee Yong; Mengzhou Xue, 

Email vyong@ucalgary.ca; xuemengzhou@zzu.edu.cn 

Abstract: 

Intracerebral hemorrhage (ICH) is a highly fatal disease that currently lacks effective treatment options. However, secondary brain injury has become a key focus in translational research, with oxidative stress (OS) identified as a central factor in ICH pathophysiology. Following ICH, hematoma components and inflammatory factors overwhelm the antioxidant defense system, triggering OS. Concurrently, neuroinflammation arises, driven by activated microglia that adopt a pro-inflammatory phenotype and release cytokines and chemokines. While neuroinflammation may support repair, it can also cause harmful secondary damage. Recent evidence indicates that NLRP3 is an important inflammasome considered a key player in OS and neuroinflammation. OS can activate the NLRP3 inflammasome by producing reactive oxygen species (ROS), further exacerbating the inflammatory response. Additionally, NLRP3 also plays an important role in regulating neuroinflammation. The activation of the NLRP3 inflammasome promotes the release of pro-inflammatory cytokines, further intensifying the neuroinflammatory response. The activation of NLRP3 is closely related to the polarization of microglia, potentially driving microglia to polarize towards the M1 type (pro-inflammatory), thereby exacerbating neuroinflammation. Therefore, we hypothesize that NLRP3 plays a critical regulatory role in OS and neuroinflammation following ICH. This review summarizes the regulatory role of the NLRP3 inflammasome in the interplay between OS and neuroinflammation, as well as its potential therapeutic targets related to ICH. 

Stroke Rehabilitation: Which is the Main Functional Outcome to Reach?

 Silly question! The only goal in stroke is 100% recovery! You just proved your incompetence to be in stroke!

Stroke Rehabilitation: Which is the Main Functional Outcome to Reach?

 Loredana Cavalli*, Andrea Guazzini, Bruno Rossi and Carmelo Chisari University of Florence, Italy

 Abstract 

 Background: 

Stroke rehabilitation targets range from treatment of spasticity to pain reduction, gait speed gain, or autonomy amelioration. A correct evaluation of individual residual capabilities is essential to select the most appropriate rehabilitative programme; furthermore the observation of rehabilitative outcomes can provide information about gait training effects and possible compensation mechanisms. 

 Aim: 

To investigate the main outcome to reach in stroke rehabilitation. 

 Methods: 

We examined retrospectively a heterogeneous sample of 119 subjects recovered for the treatment of stroke outcomes. Functional parameters were assessed before and after rehabilitative treatment, such as upper limbs motility impairment, lower limb sensitiveness, muscle trophism or tone, necessity of auxilium, Berg and Fugl-Meyer scale. 

 Results: A consistent improvement of standing equilibrium was reported, regardless of gender, stroke nature, hemiparetic side, type of rehabilitation performed, botulin toxin use and initial conditions, with an average increase of Berg and Fugl-Meyer scales score of 14% and 21%, respectively. The variation of equilibrium and motility across treatment resulted directly proportional and negatively correlated to lower limbs sensitivity impairment. On the contrary, initial equilibrium resulted inversely correlated with the variation of motility and vice versa. Interestingly, older subjects seem to better increase equilibrium and sensitivity as measured by Fugl-Meyer scale. 

 Conclusion: 

In stroke subjects any type of rehabilitation leads to a consistent improvement of standing balance. While proportional to motility and sensitivity increase, this result is inversely correlated to initial motility score, suggesting that an appropriate evaluation of the stroke patient’s functional parameters at admission contributes to select the main rehabilitation targets and the best therapeutic strategy.

The impact of inpatient and community stroke rehabilitation on health-related quality of life in New Zealand

 So, obviously a complete failure! NO measurement of 100% recovery, the only goal in stroke!

Here is your business101 requirements.

“What's measured, improves.” So said management legend and author Peter F. Drucker  

The impact of inpatient and community stroke rehabilitation on health-related quality of life in New Zealand

Stephanie G Thompson 1, Dhairya Thakkar 2, Harry McNaughton 3, William Levack 2, Anna Ranta 2

Affiliations 

• PMID: 41159514
 
• DOI: 10.23736/S1973-9087.25.08903-8

Abstract

Background: Stroke rehabilitation - both inpatient and community - is an important part of current post-stroke care, aimed at improving outcomes. However, there is a lack of recent New Zealand research exploring associations between rehabilitation and health-related quality of life (HRQoL) post stroke.

Aim: To explore associations between stroke rehabilitation and HRQoL.

Design: Secondary analysis of data from a prospective, observational study.

Setting: Twenty-eight New Zealand hospitals.

Population: Overall, 2379 patients with stroke.

Methods: Data was collected from consecutive patients with stroke who were admitted to New Zealand hospitals between 1st May and 31st July 2018. Further data collection occurred until the target sample size was reached, or until 31st October 2018, whichever occurred first. Patients were contacted for routine follow-up at three months and were invited to consent to follow-up at six and 12 months. We used the EQ-5D-3L and calculated the health utility score using weightings for the New Zealand population. We used linear regression to explore correlations between rehabilitation and HRQOL, adjusting for known confounders including stroke severity.

Results: There were 750/2379 (31.5%) patients who received inpatient rehabilitation and 838/2379 (35.2%) who received community rehabilitation. In a multivariate analysis, patients who received inpatient rehabilitation, compared to people who did not, had lower HRQoL scores at both three months (-0.07, 95% CI -0.10 to -0.04) and 12 months (-0.08, 95% CI -0.12 to -0.04). Patients who received community rehabilitation had higher HRQoL scores at 12 months (0.04, 95% CI 0.002 to 0.08)). Stratifying scores by stroke severity, we found results in favor of inpatient rehabilitation for only the most severely impaired patients and for community rehabilitation for all but the least impaired.

Conclusions: We found a negative correlation between HRQoL and inpatient rehabilitation, and a positive association between HRQoL and community rehabilitation. A combination of personal, environmental and service factors may explain this result. Future research directly comparing outcomes for patients receiving comprehensive community-based and inpatient rehabilitation, would be useful to support stroke rehabilitation service development.

Clinical rehabilitation impact: Individualized rehabilitation planning should consider social supports, the home environment, functional level and patient preference to support decision-making around rehabilitation location and optimize outcomes.

High blood pressure variability linked to brain atrophy in older adults

 How exactly is your doctor addressing arterial stiffness and neurofilament light chain problems? Oh, has DONE NOTHING, LIKE USUAL!    

Let's see how long your doctor has been incompetent!

blood pressure variability (7 posts to July 2016)

Arterial stiffness (31 posts to December 2014)

Neurofilament light chain (12 posts to January 2019)

High blood pressure variability linked to brain atrophy in older adults

The combination of high beat-to-beat blood pressure variability (BPV) and elevated pulse pressure variability -- a marker of arterial stiffness -- was linked to medial temporal lobe atrophy and increased plasma neurofilament light chain (NfL), both key markers of neurodegeneration, according to a study published in the Journal of Alzheimer’s Disease.

The findings suggest that haemodynamic instability may play a significant role in age-related brain decline, highlighting the importance of monitoring and managing BPV to protect cognitive health.

“Our findings show that even when average blood pressure is normal, instability from one heartbeat to the next may place stress on the brain,” said senior author Daniel A. Nation, PhD, University of Southern California, Los Angeles, California. “These moment-to-moment swings appear to be associated with the same kinds of brain changes we see in early neurodegeneration.”

The researchers recruited 105 older adults without major neurological or systemic diseases to investigate the relationship between BPV and markers of neurodegeneration. Participants underwent continuous blood pressure monitoring to quantify beat-to-beat variability using systolic average real variability (ARV) and pulse pressure variability via an arterial stiffness index (ASI). Brain MRI assessed medial temporal lobe atrophy, while plasma samples measured NfL and glial fibrillary acidic protein (GFAP) as biomarkers of neuronal and glial injury.

Analysis revealed that participants with both high ARV and high ASI exhibited significant left-sided medial temporal lobe atrophy, including in the hippocampus and entorhinal cortex, confirmed through region-of-interest and voxel-based morphometry analyses. This combination was also associated with elevated plasma NfL levels, indicating increased neurodegenerative activity, though GFAP levels were unaffected.

“Traditionally, we’ve focused on lowering average blood pressure numbers,” said Trevor Lohman, PhD, University of Southern California. “But this study suggests we should also be looking at how stable blood pressure is from moment to moment. Reducing these fluctuations could help protect the brain, even in people whose average readings look fine.”

The authors noted that because this was a cross-sectional study, it cannot prove cause and effect, necessitating larger, long-term studies that closely examine the links between cardiovascular and brain health.

Reference: https://journals.sagepub.com/doi/10.1177/13872877251386443

SOURCE: University of Southern California

8 Foods That Can Slow Brain Injury Recovery: Avoid These Foods to Support Your Brain Healing

 But still NOT A PROTOCOL! If we had any leadership at all in stroke, these mostly useless guidelines would be replaced by EXACT PROTOCOLS! 

Don't tell us what NOT to do; give us AN EXACT DIET PROTOCOL so there is NO confusion about what to do

8 Foods That Can Slow Brain Injury Recovery: Avoid These Foods to Support Your Brain Healing

Flint RehabLast updated on October 30, 2025

Recovering from a brain injury is a journey that affects both the body and the mind. Along with therapy, rest, and medication, nutrition plays an important role in how well the brain heals. The foods you eat can either support your recovery or make symptoms worse. Certain ingredients may increase inflammation, slow down cognitive function, or interfere with energy levels needed for healing.In this article, we’ll walk through eight foods to avoid after brain injury, why they may be harmful, and what you can eat instead.

Why Diet Matters After Brain Injury

 The brain requires a steady supply of nutrients to repair itself. Vitamins, minerals, antioxidants, and healthy fats all contribute to healing damaged cells and maintaining energy. On the other hand, processed or nutrient-poor foods can place extra stress on the brain and body. Some foods contribute to inflammation, which is especially harmful after a brain injury since inflammation can worsen swelling and slow recovery. Others can interfere with blood sugar regulation, mood, or sleep, all of which are important for rebuilding strength and mental clarity. Making thoughtful food choices is not about following a strict or complicated diet. Instead, it’s about knowing which foods to limit so that your brain has the best chance to heal.

1. Avoid Processed Foods High in Additives After Brain Injury

 Why to Avoid After Brain Injury Packaged snacks, frozen dinners, and other heavily processed foods often contain artificial additives, preservatives, and flavor enhancers. These ingredients provide little nutritional value and may trigger inflammation. They’re also high in sodium, which can contribute to high blood pressure. As individuals have a higher risk of developing cardiovascular diseases after TBI, it is important to avoid foods that may also contribute to these complications. Better Options Instead of reaching for boxed or pre-made meals, try simple whole-food choices. Fresh fruits, vegetables, lean proteins, and whole grains offer nutrients without the hidden chemicals. Preparing meals at home, even with basic recipes, helps ensure you know exactly what’s going into your body. 

2. Avoid Foods High in Added Sugar After Brain Injury 

Why to Avoid After Brain Injury Candy, soda, pastries, and other sweets can cause sharp spikes and crashes in blood sugar. For someone recovering from a brain injury, these fluctuations can increase fatigue, worsen mood swings, and interfere with concentration. Research also suggests that high sugar intake contributes to oxidative stress in the brain, making it harder for cells to repair. Better Options Choose naturally sweet foods like fresh berries, bananas, or apples. If you want a sweet treat, consider a small piece of dark chocolate, which contains antioxidants. Pairing fruit with protein or healthy fat (like apple slices with peanut butter) can also keep blood sugar steady. 

3. Avoid Fried and Greasy Foods After Brain Injury 

Why to Avoid After Brain Injury French fries, fried chicken, and other greasy meals are often loaded with unhealthy trans fats or heavily processed oils. These fats increase inflammation and can impair blood flow to the brain. Regularly consuming fried foods may also lead to sluggishness, anxiety, and/or depression, making it harder to participate in therapy or stay mentally sharp. Better Options Baking, steaming, or air frying are healthier cooking methods. Instead of fried chicken, try baked chicken with herbs. Replace greasy fast food with meals rich in omega-3 fatty acids, like grilled salmon or walnuts, which support brain health. 

4. Avoid Refined Carbohydrates After Brain Injury 

Why to Avoid After Brain Injury White bread, pasta, and many breakfast cereals are made with refined flour that has been stripped of fiber and nutrients. These foods quickly break down into sugar, leading to the same energy crashes as desserts and candy. For someone with a brain injury, unstable energy can make recovery more difficult. Choose whole-grain versions of bread, pasta, and rice. Quinoa, oats, and brown rice provide longer-lasting fuel for the brain and body. Whole grains also contain B vitamins, which are essential for nerve function and energy production 

5. Avoid Excessive Caffeine After Brain Injury 

I completely disagree, here's why. 

I'm not taking chances and do a 12 cup pot of coffee a day. 

How coffee protects against Parkinson’s Aug. 2014 

Coffee May Lower Your Risk of Dementia Feb. 2013

Coffee drinkers rejoice! Drinking coffee could lower the risk of Alzheimer’s disease 

And this: Coffee's Phenylindanes Fight Alzheimer's Plaque December 2018

New research suggests drinking coffee may reduce the risk of frailty May 2025

I think I'm in this category:  I never get the jitters or flushed skin.

Genetics determine how much coffee you can drink before it goes wrong

I'm doing a 12 cup pot of coffee a day with full fat milk to lessen my chances of dementia and Parkinsons. Tell me EXACTLY how much coffee to drink for that and I'll change. Yep, that is a lot more than the 400mg. suggested limit, I don't care! Preventing dementia and Parkinsons is vastly more important than whatever problems it can cause! 

Of course, your fuckingly incompetent? doctor did nothing with this from 2 years ago!

Dementia risk could drop by drinking just one shot daily of common beverage  August 2023

This line is great: The findings indicate that even the Espresso Martini cocktail contains the espresso's beneficial compounds - and can contribute to staving off dementia.

 Why to Avoid After Brain Injury A cup of coffee or tea can be fine for many people, but too much may worsen brain injury symptoms. High intake can increase anxiety, disrupt sleep, and lead to headaches. Since rest is essential for healing, poor sleep caused by caffeine can interfere with recovery progress. Stick to moderate amounts of caffeine—usually no more than one cup of coffee per day. Try green tea, which contains less caffeine and has calming antioxidants. Herbal teas such as chamomile or rooibos provide warmth and comfort without overstimulating the nervous system. 

6. Avoid Alcohol After Brain Injury 

For me, social connections are going to prevent dementia and that is lubricated by jazz and trivia at local bars. Also great for balance recovery, being perturbed by other patrons as you make your way to the bathroom. 

Why to Avoid After Brain Injury Alcohol directly affects the brain and can slow healing after an injury. It may interfere with medications, worsen balance issues, and impair memory. Even small amounts of alcohol can increase the risk of falls, poor decision-making, and emotional instability during recovery. Better Options Stay hydrated with water, coconut water, or sparkling water flavored with lemon or berries. For social occasions, try mocktails made with fresh fruit, herbs, and soda water. These options provide flavor and enjoyment without the negative impact on your brain. 

7. Avoid Foods High in Saturated Fat After Brain Injury 

But full fat dairy is good for you; Dairy fat from milk, butter, and cheese could actually PREVENT a heart attack September 2021)

Why to Avoid After Brain Injury Diets heavy in red meat, butter, full-fat dairy, and processed meats like bacon can increase inflammation and raise cholesterol levels. Poor circulation reduces the delivery of oxygen and nutrients the brain needs to recover. Saturated fat has also been linked to reduced memory and cognitive decline when consumed in excess. Better Options Choose lean proteins like chicken, turkey, beans, and lentils. Incorporate healthy fats from sources such as olive oil, avocados, and nuts. These fats provide energy and protect brain cells without contributing to inflammation. 

8. Avoid Artificial Sweeteners After Brain Injury 

Why to Avoid After Brain Injury Sugar substitutes like aspartame or sucralose are common in diet sodas, sugar-free desserts, and protein bars. Some studies suggest these sweeteners may negatively affect mood, memory, and gut health. For individuals with a brain injury, any added strain on mood or cognition can be unhelpful. Better Options Use natural sweeteners in moderation, such as honey or maple syrup. Stevia is another plant-based option that doesn’t cause large blood sugar spikes. Keep sweetness minimal so your taste buds gradually adjust to less sugary foods overall. Putting It All Together Avoiding these foods doesn’t mean you’ll never enjoy your favorite flavors again. Instead, it’s about finding balance and choosing options that support your brain. For example, swapping fried foods for grilled versions or replacing soda with sparkling water flavored with fruit can make a meaningful difference. Recovery requires energy, focus, and emotional resilience. The right diet helps provide these essentials while reducing setbacks caused by poor nutrition. Think of food as one of the many tools in your recovery toolkit—alongside therapy, rest, and medical care. Practical Tips for Making Dietary Changes Start small: Pick one category, like sugary drinks, and replace them with healthier alternatives. Meal prep: Having pre-chopped vegetables or cooked grains ready makes it easier to choose nutrient-dense meals. Seek support: Family members and caregivers can help by preparing meals or encouraging healthier choices.Listen to your body: Notice how you feel after eating different foods. If certain meals leave you feeling tired or foggy, they may not be serving your recovery. When to Seek Professional Guidance Every brain injury is unique, and so is every recovery journey. A registered dietitian or healthcare provider can help create a plan tailored to your needs. This is especially important if you take medications, since some foods may interact with prescriptions. Don’t be afraid to ask for help in building a recovery-friendly meal plan. The right guidance can remove stress from mealtimes and allow you to focus more fully on your healing journey.Healing after a brain injury is about giving your body and mind the resources they need. Avoiding processed foods, excessive sugar, alcohol, fried meals, and other harmful ingredients helps reduce inflammation and support brain health. By choosing whole foods rich in vitamins, minerals, and healthy fats, you can create a foundation for better energy, clearer thinking, and more effective recovery. Making small, consistent changes adds up over time. Even if progress feels slow, every healthy choice supports your brain’s resilience. With patience and mindful eating, you can nourish your recovery and feel more in control of your journey. Want additional reading? Check out the 10 Best Foods for Brain Injury Recovery (Based on Clinical Evidence) 

Flint Rehab is leading the way in neuro-rehabilitation with products that are backed by research and clinically proven to help you recover more effectively from stroke, TBI, and SCI.

Oligodendrocyte progenitor cells promote blood vessel growth after stroke

All this earlier information on blood vessel growth! Did your incompetent? doctor get protocols created in the past 15 years?

• oligodendrocytes (30 posts to May 2012)
• blood vessel formation (5 posts to April 2016)
• angiogenesis (140 posts to April 2011)

Oligodendrocyte progenitor cells promote blood vessel growth after stroke

International Society for Stem Cell ResearchOct 30 2025

Stroke is a leading cause of death and disability, affecting 1 in 4 people during their lifetime. Stroke happens when blood vessels in the brain get clogged or damaged, impairing blood flow and oxygen supply to the brain, which leads to death of neurons and other brain cells. Although brain damage can be limited by interventions to restore blood flow, most stroke survivors experience some lifelong impairments of e.g. speech, movement, or cognitive function. 

Despite the existence of immature stem cells in the brain, their role in repair is uncertain and the brain's ability to recover from stroke remains limited. Takakuni Maki, Ken Yasuda, Kazuto Tsukita, and colleagues from Kyoto University, Japan, have now demonstrated that oligodendrocyte progenitor cells (OPCs)-a well-known immature glial cell type in the brain-can promote new blood vessel formation after stroke under hypoxic conditions. The research was published today in Stem Cell Reports.

The researchers found that OPCs, whose normal task is to differentiate into oligodendrocytes that form an insulating layer around axons to support neuronal function, among other roles, can change their behavior under conditions of extremely low oxygen, such as in stroke areas in the brain, and start to interact with blood vessels to stimulate their growth. The researchers were able to demonstrate this connection when they exposed mouse OPCs in the lab to very low oxygen levels simulating stroke. When injected into the blood circulation of mice with stroke, the OPCs migrated to the stroke region and survived there for several weeks. Critically, the low oxygen-conditioned OPCs more effectively helped to limit the damage to brain tissue and partially restored movement and behavior compared with unconditioned OPCs. This was likely due to the extensive formation of new blood vessels, which is critical for restoring oxygen and nutrient supply to brain cells, found in stroke brains treated with low oxygen-conditioned OPCs.

More research will be required to confirm these results and test if low oxygen-conditioned OPCs are safe and effective to be used in patients, potentially in combination with standard interventions to promote blood flow and re-oxygenation. 

Source:

International Society for Stem Cell Research

Journal reference:

Kuwata, Y., et al. (2025). Characterizing hypoxia-orchestrated post-stroke changes in oligodendrocyte precursor cells for optimized cell therapy. Stem Cell Reports. doi.org/10.1016/j.stemcr.2025.102687

The best approach against cognitive decline in the elderly

 Do you really think your doctor can create the proper protocol on this to prevent cognitive decline post stroke?

You already have 5 lost years of brain cognition due to your stroke, don't let your incompetent? doctor make it worse.

cognitive decline (348 posts to December 2011)

The best approach against cognitive decline in the elderly

Prominence

In a randomized clinical trial of 2,111 older adults at risk for cognitive decline and dementia, a structured lifestyle intervention demonstrated significantly greater benefit on global cognition over two years compared with a self-guided intervention.

Context

• Identifying effective interventions to slow or prevent cognitive decline associated with dementia is a public health priority due to the growing number of affected individuals and the profound economic, psychological, and social impacts of the disease.

• Late cognitive decline is often attributable to mixed pathologies, and effective treatment is likely to require a diversified therapeutic strategy to address the different mechanisms associated with Alzheimer's disease and vascular disease.

• Recent advances in the use of anti-amyloid antibodies demonstrate evidence of slowing the specific clinical progression of Alzheimer's disease, however, these treatments are only approved for individuals with confirmed disease.

• Non-pharmacological strategies targeting modifiable risk factors offer a promising, low-cost, accessible, and safe approach with the potential to reduce the incidence of dementia by up to 45%.

• The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) demonstrated significant cognitive benefit after two years of intervention in multiple domains in older adults at high risk of dementia.

• The World-Wide FINGERS network was launched in 2017 to promote global collaboration, protocol alignment, and data sharing between non-pharmacological risk reduction trials.

Methodology

• Randomized, single-blind, multicenter clinical trial that included 2,111 participants at five clinical sites in the United States, with recruitment from May 2019 to March 2023 and final follow-up until May 14, 2025.

• Inclusion criteria were defined to select a population at higher risk of cognitive decline, including ages between 60 and 79 years, sedentary lifestyle, and inadequate diet, in addition to at least two other factors such as family history of memory impairment, cardiometabolic risk, race and ethnicity, advanced age, and gender.

• Participants were randomized in a 1:1 ratio to either the structured intervention (n = 1,056) or the self-guided intervention (n = 1,055), both of which encouraged increased physical and cognitive activity, a healthy diet, social engagement, and cardiovascular health monitoring.

• The primary comparison was the difference between the intervention groups in the annual variation in global cognitive function, assessed by a composite measure of executive function, episodic memory, and processing speed, over two years.

When care teams unite, stroke outcomes improve

 

This is the whole problem in stroke enumerated in one word; 'care'; NOT RECOVERY! 

Our non-existent stroke leadership should be demanding RECOVERY NOT 'CARE'!

My god, anyone in the business world would be fired immediately for managing or caring about something rather than delivering RESULTS. And this is why this is a complete fucking failure! This does nothing to guarantee recovery for survivors!

If your hospital is touting 'care' it means they are a failure because they are delivering 'care'; NOT RECOVERY! I would never go to a failed hospital! Anytime I see the word 'care' associated with a stroke hospital; I immediately think fucking failure!

YOU have to get involved and change this failure mindset of 'care' to 100% RECOVERY! Survivors want RECOVERY, NOT 'CARE'!

I see nothing here that states going for 100% recovery! You need to create EXACT PROTOCOLS FOR THAT!

ASK SURVIVORS WHAT THEY WANT, THEY'LL NEVER RESPOND 'CARE'! This tyranny of low expectations has to be completely rooted out of any stroke conversation! I wouldn't go there because of such incompetency as not having 100% recovery protocols!

RECOVERY IS THE ONLY GOAL IN STROKE!

GET THERE!

When care teams unite, stroke outcomes improve

9 minute talk at link, which I'm certainly not listening to. 

Stroke remains a leading cause of death and disability in the U.S. Yet about 80% of strokes are preventable, according to the American Heart Association (AHA). 

As one of the nation’s leading providers of stroke careNOT RECOVERY!), HCA Healthcare and the HCA Healthcare Foundation are collaborating with the AHA to help improve the full continuum of stroke careNOT RECOVERY!)—from patient awareness and prevention to prompt treatment and reducing recurrence.

AMA Health System Member Program

Providing enterprise solutions to equip your leadership, physicians and careNOT RECOVERY!) teams with resources to advance your programs while being recognized as a leader. 

Join Us

HCA Healthcare is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and careNOT RECOVERY!) teams with resources to help drive the future of medicine.

The Getting to the Heart of Stroke™ initiative focuses on improving patient outcomes with increased collaboration between neurology and cardiology, evidence-based education and interventions, and identifying and addressing health-related social needs.

“We started by asking ourselves, if the community is unaware of how to lower their risk of having a stroke or if they're unaware of those warning signs and symptoms, how can we help them? Then, when they reach our healthcare system, how can we ensure we are providing of the best careNOT RECOVERY!) possible?” said cardiologist Steven V. Manoukian, MD, a senior vice president at HCA Healthcare and American Heart Association 2024 Healthcare Volunteer of the Year. 

Working with the AHA to design and implement an initiative to improve patient and community awareness and amplify clinical findings was a natural fit.

“No other organization matches the American Heart Association’s strength across the stroke continuum,” said Dr. Manoukian. “Their deep community engagement and commitment to education are unparalleled, and they're the source of the clinical guidelines health careNOT RECOVERY!) professionals rely on.” 

“They're the No. 1 voice in cardiovascular clinical knowledge, science and research … And they have scientific symposia which allow us to amplify our shared mission to tens of thousands of healthcare professionals,” he added. “This collaboration has been a home run.”

At the clinical level, HCA Healthcare launched Getting to the Heart of Stroke as a pilot program at 10 of its comprehensive stroke centers to foster collaboration and knowledge sharing between cardiologists, neurologists and emergency medicine physicians. Together, they are improving stroke careNOT RECOVERY!) using evidence-based standards and protocols guided by AHA’s recommendations.

“When you have clinical champions working together, rowing the boat in the same direction to ensure evidence-based testing, optimal treatment and thorough investigation of the cause of a stroke, we achieve better outcomes for patients and greater health care value as well,” said Dr. Manoukian. 

The pilot program has, in fact, moved the needle, particularly in identifying the cause of a patient’s stroke. Comprehensive in-hospital diagnostic testing and cardiac monitoring have improved stroke cause identification by 33%, which can significantly reduce stroke recurrence.

Bringing careNOT RECOVERY!) teams together

The pilot program focused on breaking down silos between clinical specialties. This began with identifying and understanding knowledge and capability gaps and improving communication among stroke specialists.

To create stronger, seamless collaborations, HCA Healthcare’s pilot program leaders identified physicians who were engaged, open and committed to shepherd multidisciplinary teams through new processes, protocols and systems.

“It starts with identifying champions across teams who can help bridge knowledge gaps and foster collaboration centered around patient careNOT RECOVERY!),” said Dr. Manoukian. “The diverse perspectives of our frontline stakeholders—whether nurses, physicians or the entirety of the health care team—is what drives meaningful change.”

From there, HCA Healthcare invested in infrastructure, technology and other tools to support more effective careNOT RECOVERY!) across disciplines.