Ischemic Stroke
No matter how bad things are, they can always be worse. So what if my stroke left me with a speech impediment? Moses had one, and he did all right - Kirk Douglas
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image by: Different Strokes For Different Folks
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New Findings Could Save Lives of More Stroke Patients
Many more stroke victims than previously thought can be saved from disability or death if doctors remove blood clots that are choking off circulation to the brain, a new study has shown.
“These striking results will have an immediate impact and save people from lifelong disability or death,” Dr. Walter J. Koroshetz, director of the National Institute of Neurological Disorders and Stroke, said in a statement. “I really cannot overstate the size of this effect.”
The key finding is that there is often more time than doctors realized in which brain cells can still be rescued by a procedure to remove the clot. Traditional guidelines have set a limit of six hours after stroke…
Resources
For Many Strokes, There’s an Effective Treatment. Why Aren’t Some Doctors Offering It?
A charismatic, riveting speaker, Dr. Hoffman has given educational courses across the country and many medical professionals have listened to informational tapes in which he presented his critique of the evidence. And his influence has spread.
A Normal Head CT Scan Does Not “Rule Out” Ischemic Stroke – Part I
An early stroke can be a treatable stroke, but if a patient is sent home on the assumption that a normal CT scan “ruled out” a stroke, then the only evidence-supported medical therapy for treatment has been denied to that person.
A Normal Head CT Scan Does Not “Rule Out” Ischemic Stroke – Part II
As a follow up to last week’s post about head CT scans failing to demonstrate evidence of ischemic stroke in certain situations (early stroke, strokes of small sizes, strokes in the brainstem or cerebellum), I wanted to share several cases illustrating the truth behind the assertion.
What You Should Know About Ischemic Stroke
With a brain attack, every second counts.
Call To Action: Americans Fear Terrorism More Than What Is Likely To Kill Them
I remain much more fearful of having a stroke than I do of losing my life in a terrorist attack. Yes, national security is an important issue; however, as we battle threats that are much more likely to kill and disable Americans than terrorist attacks, let us place our fears where fear is warranted, and channel this energy into action.
For First Time, Treatment Helps Patients With Worst Kind of Stroke, Study Says
After three decades of failure, researchers have found a treatment that greatly improves the prognosis for people having the most severe and disabling strokes. By directly removing large blood clots blocking blood vessels in the brain, they can save brain tissue that would have otherwise died, enabling many to return to an independent life.
Ischemic Stroke Recovery Guide
It’s important to remember that a stroke has the potential to harm a subject in several ways. Not only are there many possible physical side effects, but mental and emotional complications can also surface because of an attack. However, the seriousness of these issues is determined by the severity of the stroke itself, and the nature of the issues may vary depending on what parts of the brain are affected.
Popular heartburn medication may increase ischemic stroke risk
"At one time, PPIs were thought to be safe, without major side effects," he said, "This study further questions the cardiovascular safety of these drugs."
Reflecting on Cerebral Venous Sinus Thrombosis, and the U.S. Presidential Election
The most common initial symptoms of CVST are headache, visual changes, and/or seizure. A headache that continues to escalate for days to weeks, especially in a patient taking birth control pills, who is pregnant, or who has a history of abnormal clotting should undergo MRI of the brain.
Young adults with acute ischemic stroke are more likely to receive IV t-PA than their older counterparts, and have lower rates of bleeding
I am finally able to share the results of the largest study to date evaluating treatment of young adults in the first hours after the onset of ischemic stroke!
Time is Brain – Acute Ischemic Stroke Part 2: Mechanical Thrombectomy
Mechanical thrombectomy has revolutionized stroke care for patients with large vessel occlusions (LVOs). LVOs account for ~40% of all AIS, and prior to endovascular therapy more than half of these patients suffered significant post-stroke disability (modified Rankin Scale (mRS) 4-5) or death (mRS 6). This post reviews who qualifies for mechanical thrombectomy, the process of screening, and how the field of interventional neurology continues to evolve.
Time is Brain – Acute Ischemic Stroke Part I: Vascular Syndromes and Thrombolysis
About ~800K people have a stroke in the US every year (1 person every 40 seconds) and stroke is a leading cause of serious long-term disability (PMID: 31992061). But prior to ~2015, outside of trials, the acute ischemic stroke patient either arrived within 4.5 hours and got tPA or they got supportive care. And, unfortunately, very few patients arrive within the 4.5 hour time window. Things are dramatically different now. The endovascular era in stroke care has revolutionized care for patients with large vessel occlusions (LVO) – which is the subgroup of patients that before the reperfusion era accounted for the highest stroke morbidity and mortality. There is now effective treatment for those who present within 24 hours.
New Findings Could Save Lives of More Stroke Patients
Many more stroke victims than previously thought can be saved from disability or death if doctors remove blood clots that are choking off circulation to the brain, a new study has shown.
Act FAST
Learn the many warning signs of a stroke. Act FAST and CALL 9-1-1 IMMEDIATELY at any sign of a stroke. Use FAST to remember the warning signs.
MedlinePlus
A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Ischemic stroke is the most common type. It is usually caused by a blood clot that blocks or plugs a blood vessel in the brain. This keeps blood from flowing to the brain.
The Internet Stroke Center
Ischemic stroke is by far the most common kind of stroke, accounting for about 88 percent of all strokes. Stroke can affect people of all ages, including children. Many people with ischemic strokes are older (60 or more years old), and the risk of stroke increases with age.
UpToDate
The use of thrombolytics for acute stroke requires care in a hospital that is able to coordinate emergency services and offers rapid consultation with a neurologist (physician who specializes in the brain) and has intensive care services and imaging (eg, CT scan or MRI). Not all hospitals are able to provide these services, and in this situation it may be necessary to transfer the patient to a hospital that can. It is best if the ambulance or family can bring the stroke patient directly to a hospital that is able to give this care, rather than to transfer the patient later. Side effects – Overall, it is estimated that alteplase treatment is 10 times more likely to help than to harm. However, approximately 1 in 15 patients who is given thrombolytic therapy develops excessive bleeding (hemorrhage) in the brain; this type of bleeding can be fatal. It is estimated that of 30 patients treated, one is harmed by the treatment

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