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 treatment goals. Show all posts
Showing posts with label treatment goals. Show all posts

Thursday, February 21, 2019

Balloon-guided catheter surgery provides better outcomes for stroke patients

Wow, Using the tyranny of low expectations in trying to justify that 'better' is good enough. 100% recovery is the goal of all survivors. NOT restoring blood flow.  The goals of the doctors and the patients need to align with survivors goals taking precedence.

Balloon-guided catheter surgery provides better outcomes for stroke patients

Patients who have experienced a stroke as a result of blockages of the arteries in the brain have better outcomes with the use of balloon-guided catheter surgery as compared to having a conventional guided catheter procedure.
Clot retrieval is typically the treatment for large vessel occlusions (LVO), which are strokes that result from a blockage in one of the major arteries of the brain. Treatment options include use of a balloon-guided catheter or a conventional guided catheter.
Researchers from Boston University School of Medicine (BUSM), Mercy Health Neuroscience Institute of Toledo, University of Toledo and several other centers compared two groups of patients. In one group, patients experienced a LVO stroke and underwent treatment with a stent retriever (device used to unclog blood clots) with a balloon-guided catheter. During clot retrieval, the balloon on the guide catheter was temporarily inflated in the carotid artery to stop blood flow as the clot was being removed. In the second group, patients had a LVO stroke and underwent treatment with a stent retriever using a conventional guide catheter.
"When we compared both groups, patients who had balloon-guided catheter had better restoration of blood flow scores and better clinical outcomes," explained corresponding author Thanh Nguyen, MD, associate professor of neurology at BUSM and director, Interventional Neuroradiology and Interventional Neurology at Boston Medical Center (BMC).
"Achieving complete or near complete blood flow is the goal to restore strength, language, coordination, reflexes and sensation to patients suffering from ischemic stroke," said senior author Osama Zaidat, MD, who established the TRevo Acute Ischemic Stroke Thrombectomy (TRACK) Registry.
"Stopping arterial flow is an important step that can improve restoration of blood flow, reduce the number of blood clot emboli to a new area and potentially improve clinical outcome," added co-author Mohamad Abdalkader, MD, assistant professor of radiology at BUSM and interventional neuroradiologist at BMC.
"Our study adds to the growing body of evidence that highlights the potential of balloon-guide catheters to improve stroke patient outcomes. Future studies are necessary to fully understand the role of this technology in a larger patient population," said co-author Alicia Castonguay, PhD, assistant professor in the College of Medicine and Life Sciences at The University of Toledo.
This study builds on Nguyen, Zaidat and Castonguay's prior seminal publication from the multicenter national North American Solitaire Acute Stroke (NASA) Registry demonstrating positive effect of balloon guide catheters in improving reperfusion and clinical outcome in patients with large vessel occlusion stroke published in the journal Stroke in 2014.
These findings appear in the Journal of NeuroInterventional Surgery.

Thursday, July 5, 2018

Identifying unmet needs in long-term stroke care using in-depth assessment and the Post-Stroke Checklist – The Managing Aftercare for Stroke (MAS-I) study

This is so simple. You didn't get your stroke patients 100% recovered. That is the only goal you should be working on. Solve that and all these unmet need fall away. I don't give a shit that that is a BHAG(Big Hairy Audacious Goal) of 100% recovery for all survivors!
http://journals.sagepub.com/doi/full/10.1177/2396987318771174?




Detailed data on the long-term consequences and treatment of stroke are scarce. We aimed to assess the needs and disease burden of community-dwelling stroke patients and their carers and to compare their treatment to evidence-based guidelines by a stroke neurologist.

We invited long-term stroke patients from two previous acute clinical studies (n = 516) in Berlin, Germany to participate in an observational, cross-sectional study. Participants underwent a comprehensive interview and examination using the Post-Stroke Checklist and validated standard measures of: self-reported needs, quality of life, overall outcome, spasticity, pain, aphasia, cognition, depression, secondary prevention, social needs and caregiver burden.

Fifty-seven participants (median initial National Institutes of Health Stroke Scale score 10 interquartile range 4–12.75) consented to assessment (median 41 months (interquartile range 36–50) after stroke. Modified Rankin Scale was 2 (median; interquartile range 1–3), EuroQoL index value was 0.81 (median; interquartile range 0.70–1.00). The frequencies for disabilities in the major domains were: spasticity 35%; cognition 61%; depression 20%; medication non-compliance 14%. Spasticity (p = 0.008) and social needs (p < 0.001) had the strongest impact on quality of life. The corresponding items in the Post-Stroke Checklist were predictive for low mood (p < 0.001), impaired cognition (p = 0.015), social needs (p = 0.005) and caregiver burden (p = 0.031). In the comprehensive interview, we identified the following needs: medical review (30%), optimization of pharmacotherapy (18%), outpatient therapy (47%) and social work input (33%).

These results suggest significant unmet needs and gaps in health and social care in long-term stroke patients. Further research to develop a comprehensive model for managing stroke aftercare is warranted.(Wrong, further research needed to get to 100% recovery, work on the correct goal you blithering idiots.)
Clinical Trial Registration: clinicaltrials.gov NCT02320994.