A stroke is the interruption of blood to the brain.  It is most commonly caused by vascular interruption from a blood clot or cholesterol blockage or cholesterol embolus.  Rarely, it may also be caused by fungal endocarditis and fungal emboli following mitral valve replacement surgery.

Strokes have been classified as “brain attacks.”  [...]]]> Source:  BBC Health; The Lancet

A stroke is the interruption of blood to the brain.  It is most commonly caused by vascular interruption from a blood clot or cholesterol blockage or cholesterol embolus.  Rarely, it may also be caused by fungal endocarditis and fungal emboli following mitral valve replacement surgery.

Strokes have been classified as “brain attacks.”  Like heart attacks, strokes can damage and kill tissue and result in temporary or permanent brain, injury, nerve injury (palsy), paralysis, loss of coordination and balance,neurological impairment, loss of speech and death.  Predicting them and treating them before they occur can be critically important.

Researchers are calling for new guidelines for GP’s (General Practitioners or Primary Care Providers here in the US) to ensure that blood pressure remains at a steady level.  While lower is preferential, it appears to be the fluctuation (change up or down) of blood pressure that determines the risk of stroke.   Current guidelines call for a re-check of a high blood pressure only.  If that second pressure is normal there is rarely treatment in the form of medication.  And medication alone might not be the answer.  Studies published in The Lancet have suggested that beta blockers (a common class of heart medication) may increase variation in blood pressure.

Like the fable the tortoise and the hare, it appears that slow and steady really does win the race when it comes to blood pressure and decreasing the risk of stroke or at the very least predicting those patients at risk for stroke.

~Posted by D.M. Schwadron, Esquire

Apparently stopping death or irreparable damage from a heart attack could be as simple as inflating a blood pressure cuff.  This according to a recent Danish (The Country) study.

How does it work and why does no one seem to know about this?  Well, it is thought that a brief stoppage [...]]]> Source: U.S. National Institutes of Health

Apparently stopping death or irreparable damage from a heart attack could be as simple as inflating a blood pressure cuff.  This according to a recent Danish (The Country) study.

How does it work and why does no one seem to know about this?  Well, it is thought that a brief stoppage of blood flow improves the ability of organs to withstand stress and prevents tissue damage.  The admittedly small study of 142 patients rushed to hospital emergency rooms for heart attacks who received this treatment managed to retain 30% more of their heart tissue than those who did not.  The cuff was inflated for 4 minutes, relaxed and then inflated again.  Repeating this procedure 4 times appears to have done the trick according to the study’s author, Dr. Hans Erik Botker, a professor of cardiology.

Unfortunately it may take some time before the rest of the world adopts the European model of treatment. One group at Emory University in Atlanta is currently attempting similar treatment here in the United States.  Dr. Jacob Vinten-Johansen has added the inflation variation with a balloon catheter, slightly more invasive.  According to Dr. Vinten-Johansen, “The United States cardiology community is a bit slower to embrace these things and the regulatory situation is better in Europe.”

Regulations here in the States require a consent for what is deemed an “experimental procedure.”  Not always something easy to obtain (No, not because of trial lawyers) as patients having heart attacks aren’t necessarily able to provide a consent.  Similar techniques are being used to attempt to treat stroke as well.

~Posted by D.M. Schwadron, Esquire

No, this will not help your golf game. But it may save your life. Remember Night Time Radiology? Yeah, it’s like that. High quality videoconferencing systems have been accepted as, “[A]n effective avenue to eliminate disparities in access to acute stroke and TIA (transient [...]]]> Source: American Heart Association (AHA) and American Stroke Association (ASA) 05/2009

No, this will not help your golf game. But it may save your life. Remember Night Time Radiology? Yeah, it’s like that. High quality videoconferencing systems have been accepted as, “[A]n effective avenue to eliminate disparities in access to acute stroke and TIA (transient ischemic attack or “mini stroke”) care, erasing the inequities introduced by geography, income or social circumstance.” Great PR Quote, huh?

In simpler terms, not everyone has equal access to good quality medical care, particularly those who are poor or regionally isolated (think living on a mountain). Enter the video phone. “Telestroke” invloves a specialist (neurologist or neuroradiologist) and a bi-directional video and audio conferencing system to interact with a doctor at bedside for “real time” consultation and treatment recommendations. One call to a specialist who can access CT and MRI results could result in an immediate, or rapid, diagnosis of a stroke.

And when one is having a stroke, time until treatment is initiated is extremely important. Oh and the author of that great PR quote, Dr. J. Donald Easton, along with other similarly obtuse quotes, and author of the article recommending use of this technology is also a “consultant/advisor” for the companies which produce the technology.

While consider the source applies, this actually is a valuable medical technology.

posted by David Marc Schwadron, Esq.