What this means is that there are NEVER strokes too good/small to treat. So your doctor has a lot of research to get accomplished to see what interventions are needed to recover from this problem. COVID-19 has this problem on a massive scale, thrombi all over the place.
Your action point on this is to make damn sure you have all the classic
symptoms, lost sensation, slurred speech, lack of movement on one side,
dropped mouth. You don't want to be classified as too good to treat.
Every single stroke coming into your stroke hospital should have a
protocol to follow. There is never a stroke that is too good to treat.
You never magically recover from a stroke. Your doctor should never have
to make a subjective decision. You have an objective damage diagnosis(The NIH Stroke Scale is not objective so we have a problem right from the start.).
What should follow directly from that is a stroke protocol to remove
the clot or stop the bleeding and then a protocol to stop the neuronal cascade of death or the hemorrhage cascade of death. This is so fucking simple, why can't it be done? Laziness? Incompetence? Or just don't care? No leadership? No strategy? Not my job?
December 2012
Increased blood flow to the brain after a microscopic stroke doesn’t mean that part of the brain has recovered. At least not yet.
A
study in
Science Advances
by Rice University neuroengineer Lan Luan and her colleagues used
advanced neural monitoring technology to discover a significant
disconnect between how long it takes blood flow and brain function to
recover in the region of a microinfarct, a tiny stroke in tissue less
than 1 millimeter in size.
The study led by Luan, a core faculty
member of Rice’s Neuroengineering Initiative, shows “a pronounced
neurovascular dissociation that occurs immediately after small-scale
strokes, becomes the most severe a few days after, lasts into chronic
periods and varies with the level of ischemia,” the researchers wrote.
The
study in rodent models revealed the restoration of blood flow in the
brain occurs first, followed by restoration of neuronal electrical
activity. They observed that neuronal recovery could take weeks even for
small strokes, and possibly longer for larger strokes.
The study
required implants and instrumentation designed to monitor both blood
flow and brain activity simultaneously before, during and after the
onset of strokes.
“This started with the device,” said Luan, an
assistant professor of electrical and computer engineering at Rice’s
Brown School of Engineering, who developed a flexible neural electrode
with co-author Chong Xie while both were at the University of Texas at
Austin. “That was my transition from being trained as a material
physicist to neuroengineering.
“As soon as we had the electrodes,
I wanted to use them to understand brain functions and dysfunctions in a
domain that was difficult to probe with previous technology,” she said.
“The electrodes are extremely flexible and well suited to be combined
with optical imaging in exactly the same brain regions.”
The
electrodes were combined with optical lines able to measure blood flow
by recording laser speckle patterns. The combined data, gathered for as
long as eight weeks, gave the researchers an accurate comparison between
blood flow and electrical activity.
“The strokes we focus on are
so small that when they happen, it’s very hard to detect them from
behavioral measures,” Luan said. “We would not easily see impairment in
animal locomotion, meaning the animal could walk away just fine, from a
lay perspective.
“The implications in humans are similar,” she
said. “These microinfarcts can occur spontaneously, especially in aged
populations. Because they’re so tiny, it’s not like you’re having a
stroke. You will not notice it at all. But it has been long hypothesized
that it’s related to vascular dementia.”
Luan said the
neurological impact of individual microinfarcts is largely unknown.
“That’s what motivated us to set up a series of experiments to really
directly measure the impacts of those extremely small-scale injuries,”
she said.
While the study would be hard to replicate in humans,
the implications could improve diagnoses of patients who suffer
microinfarcts.
“There are a lot of similarities in neurovascular
coupling in rodent models and in humans,” she said. “What we observed in
rodents likely has a similar signature in humans, and I hope that can
be of use to clinicians.”
Luan said she is continuing her
research at Rice, supported by a five-year R01 grant from the National
Institute of Neurological Disorders and Stroke.
“We’re interested
in knowing not just how a single microinfarct would alter neural
activity but also, cumulatively, whether the effect of multiple
microinfarcts that occur at different times would be stronger or weaker
than the sum of the individuals,” she said.
Reference
He
et al.
(2020). Multimodal mapping of neural activity and cerebral blood flow
reveals long-lasting neurovascular dissociations after small-scale
strokes.
Science Advances. DOI:
https://doi.org/10.1126/sciadv.aba1933
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