Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective 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.

Showing posts with label microbeads. Show all posts
Showing posts with label microbeads. Show all posts

Wednesday, August 31, 2016

Beware of wake-up stroke

I personally think the solution to this problem is magnetic delivery of microbeads of tPA directly to the location of the clot. A much smaller bolus would be needed reducing the side effects of bleeding elsewhere. But since we have NO stroke leadership or strategy this will take decades to come about.
Will no one think of the stroke survivors and actually do something to help them?
This solution maybe from May, 2016.

Stroke victims' new saviour...magnetic blood: Pioneering research could transform treatment of killer condition 

Or maybe this solution from March, 2015

Magnetic nanoparticles could stop blood clot-caused strokes

 

Beware of wake-up stroke 

Thomas (50) (name changed) remembers the panic he felt that morning when he woke up and discovered that something was seriously wrong.
He could not move from the bed because the entire right side of his body was weak. He tried to wake up his wife by calling her but all he could manage was some garbled words.
It was after 8 a.m., when he was rushed to the emergency wing of Sree Chitra Tirunal Institute for Medical Sciences and Technology, where he was immediately rushed in for MRI imaging studies.
“He had presented with what is known as the “wake-up stroke,” wherein a patient awakens with symptoms of a stroke which were not there when he fell asleep.
Imaging studies showed that the brain had suffered only minimal damage and that there was a huge salvageable brain area.
There was a major clot in the main cerebral artery, which we removed using mechanical thrombectomy (removing clot using a device called Solitaire).
He made good recovery and walked out of the hospital,” says P.N. Sylaja, Professor of Neurology, SCTIMST. Approximately 25 per cent of ischemic strokes (strokes which are caused by a blood clot in the brain arteries) are wake-up strokes, wherein patients who go to sleep normally, wake up with stroke symptoms
Intravenous thrombolysis using a recombinant tissue plasminogen activator (rtPA) or clot-busting drug can improve the clinical outcomes of patients with acute ischemic stroke if it is administered within the first 4.5 hours of the stroke onset
The time of the onset of stroke is the key factor on which safe therapeutic decisions are based. Wake-up strokes present a therapeutic dilemma for neurologists because the time of the onset of stroke is unknown. Many patients with wake-up strokes thus suffer from poor outcomes because they are not taken to be candidates for tPA as it can only be delivered within the specified time window.
Delay in treatment has always been a problem in wake-up strokes because often the family might be late in discovering that the person has suffered a stroke and there might be multiple reasons for delays in reaching the hospital too.
“Many recent studies on wake-up strokes however show that most of these strokes actually happen in the morning hours and that the stroke itself may be what woke them up.
So these days, such patients are subjected to advanced CT/MRI Perfusion studies, which can tell us how much of the brain has suffered irreversible damage and how much can be salvaged and if thrombolysis can help him,” Dr. Sylaja says.
Perfusion studies can clearly indicate if significant time delay has occurred after the onset of stroke nad if the patient will benefit from thrombolysis
Wake-up strokes are currently an important area of discussion with large randomised controlled clinical trials happening world over on how best to treat wake-up strokes and the efficacy of IV thrombolysis and endovascular mechanical thrombectomy options.
The patho physiology of wake-up strokes phenomenon is not fully understood and is linked to a combination of bodily changes in the circadian cycle, such as adrenalin secretion, platelet aggregation (leading to clots) or the normal surge in one’s blood pressure, all seen in the early morning hours.
Reporting by
C. Maya
Time of the onset of stroke is the key factor on which safe therapeutic decisions are based

Monday, May 23, 2016

Stroke victims' new saviour...magnetic blood: Pioneering research could transform treatment of killer condition

I first started suggesting this in Oct. 2012.
http://www.dailymail.co.uk/health/article-3602331/Stroke-victims-new-saviour-magnetic-blood-Pioneering-research-transform-treatment-killer-condition.html
Injecting microscopic magnetic beads into the blood of stroke victims could transform treatment of the killer condition, which strikes 152,000 Britons each year.
The pioneering treatment, called magnetically enhanced diffusion, helps ‘push’ life-saving drugs through the circulatory system 30 times faster that they would normally travel.
One in five strokes – typically caused by a blood clot blocking a vessel in the brain and starving the area of oxygen – prove fatal. Half of all survivors are left disabled.
Pictured: A diagram shows how the magnetic beads help 'push' medication around the body in a pioneering new treatment for stroke victims
Pictured: A diagram shows how the magnetic beads help 'push' medication around the body in a pioneering new treatment for stroke victims
Timing of treatment is crucial as the longer it takes to break down the clot with a special blood-thinning drug, the greater the damage and chance of lasting disability.
Studies show that the thinning drug, alteplase, needs to be given within four hours of the onset of stroke symptoms for it to be effective. 
Injecting it into the brain is not an option as this direct approach would also be damaging.
Instead the procedure, known as thrombolysis, relies on the active compounds being delivered to the site of the blockage in the bloodstream. But the clot can reduce the speed of the circulation.
Dr Richard Perry a consultant neurologist and stroke specialist at University College Hospital, where the new treatment is being studied, said: ‘It’s like a busy motorway blocked by a crash, where the emergency services have difficulty getting through. The drugs can take some time to reach the clot.’
But by introducing tiny iron oxide beads, developed by US based company Pulse Therapeutics, research has shown that the effectiveness of the drugs is increased significantly. 
The beads, which are smaller than a blood cell, are injected through a vein in the arm, immediately after the patient has been given alteplase, also injected into the arm.
A device containing a fast-rotating magnet is then placed next to the patient’s head and the magnetic force created helps propel the drugs along the blocked vessels to break down the life-threatening clot.
Once they have done their job, the beads are naturally absorbed then secreted.
An international study presented at the America Stroke Association conference showed that when given within three hours, 33 per cent of patients did not have significant disability afterwards, compared with 23 per cent of those who did not receive the therapy. 
However, even with clot-busting treatment, about six out of ten patients had significant disability(and the simple reason for that is that you still haven't addressed the neuronal cascade of death).
Stroke is the third biggest cause of death in the UK, behind cancer and heart disease, affecting one person every five minutes.
High blood pressure is the most important risk factor, contributing to half of all cases.

Sean Morris, CEO of Pulse Therapeutics, said: ‘Stroke is an enormous problem worldwide. Time counts in treating these patients because every minute, millions of neurons die. While the heart muscle can recover after a heart attack, these brain cells just die.’
Dr Perry added: ‘For most stroke patients, the only treatment that can reduce the disability from their stroke is thrombolysis. 
'Although it is important to deliver this treatment to stroke patients where possible, most patients who receive the treatment into a vein do not derive a clear benefit, and if the stroke is caused by a blockage in a large artery the proportion is particularly low.
‘While directly pulling the clot out – thrombectomy – improves results considerably, there are very few centres where this treatment can be offered, and even in the UK most patients will not benefit from this .
‘One important reason for the low success rate of the intravenous clot-busting drug is likely to be poor penetration of the thrombolytic drug to the clot that needs to be dissolved.
‘The approach of using iron microbeads to stir the blood and improve access of the clot-busting drug to the clot is exciting and innovative and we are eager to test the therapy in stroke patients.’