A blood clot and a stroke treatment drug walk into a hospital

 I'm sure they didn't mention that the drug is only the first step to recovery, and it only fully works 12% of the time. Nothing is available after that to get you 100% recovered. SO, YOU'RE FUCKING SCREWED BECAUSE YOU HAVE FUCKING FAILURES OF STROKE ASSOCIATIONS NOT SOLVING STROKE TO 100% RECOVERY!

A blood clot and a stroke treatment drug walk into a hospital

Kelly Trynosky was covered in red balloons. Cesar Velasco wore a sparkly gold jacket and visor.

     

Together, the two team members recently roamed the hallways of WellSpan Ephrata Community Hospital as part of a program called “Clots and Coffee,” designed to raise awareness about stroke symptoms and treatment during Stroke Awareness Month.

Kelly, director of clinical services, was dressed in a red visor and body full of balloons to simulate a blood clot, which often causes a stroke. Cesar, stroke program coordinator, wore his shiny jacket and visor to represent the “gold standard” for stroke treatment, a drug called Tenecteplase (“Call me TNK,” he told folks, smiling.)

The two pushed a cart with coffee and doughnut holes, gave impromptu pop quizzes and handed out prizes (tickets to Stormer baseball games in Lancaster) in departments across the hospital.

  

There was a lot of laughter and fun. But also a lot of learning.

The main message the pair shared was “BE FAST,” the acronym about stroke symptoms and response. B is for balance issues; E is for eyesight changes; F is for facial droop; A is for arm weakness; S is for speech difficulty; and T is for time, which is essential after a stroke. Do not wait to call 911 if you see these symptoms.

A Reality Check for Minimally Invasive Evacuation Surgery on Sudden Brain Bleeds

 Since everything in stroke is a fucking failure, you better not have one!

NOTHING RIGHT NOW WILL GET YOU FULLY RECOVERED! Stroke is a complete shitshow of failure!

This proves the complete failure:

1. tPA full recovery? Better than 12%?
2. rehab full recovery? Better than 10%?

A Reality Check for Minimally Invasive Evacuation Surgery on Sudden Brain Bleeds

      Null results from MIND trial leave room for potential benefit with earlier intervention

by Nicole Lou, Senior Staff Writer, MedPage Today February 6, 2025

LOS ANGELES -- A strategy of minimally invasive surgery (MIS) for spontaneous intracerebral hemorrhage (ICH) failed to meet expectations in the MIND trial.

Patients who underwent MIS with the Artemis NeuroEvacuation device ended up with virtually the same modified Rankin Scale (mRS) score at 180 days as peers who had medical management alone, supported by both intention-to-treat (mean OR 1.03, 95% CI 0.62-1.72) and by per-protocol analysis (mean OR 1.29, 95% CI 0.76-2.20), according to David Fiorella, MD, PhD, of Stony Brook Medical Center in New York.

There had been some early clinical benefit detected at the 30-day mark (OR 4.23, 95% CI 2.36-7.57) that applied to deep and lobar bleeds -- but this did not persist to 90 or 180 days, Fiorella told the audience here at the International Stroke Conference.

Fiorella maintained that in MIND, hematoma evacuation with MIS was beneficial for patients with deep and lobar ICH as it produced substantial hemorrhage reductions with an 80.7% evacuation rate. Notably, the MIND trial had been stopped early due to diminishing odds of success, and was left underpowered for the main analysis of treatment size.

As for safety, the trial saw low 30-day mortality overall, reaching a similar 9.8% with medical management and 7.2% with MIS (P=0.6167) on an as-treated basis.

The goal of MIS is controlled aspiration of tissue and/or fluid from a brain bleed. The concept of MIS had been validated previously in a high-profile trial using another device. That study, ENRICH, had shown neurological benefit to MIS for patients with acute ICH, particularly lobar supratentorial hemorrhages, at 180 days. The researchers had stopped enrolling patients with anterior basal ganglia hemorrhage for futility.

ENRICH operators had been told to evacuate bleeds with suction and the Myriad device. In contrast, MIND tested the Artemis NeuroEvacuation device designed to target an area markedly narrower than the device used in ENRICH.

"While safe and effective at removing hematomas, minimally invasive surgery for non-traumatic intracerebral hemorrhage did not improve overall outcomes in the MIND study. These data are in line with ENRICH in that evacuation of deep ICH is not currently clinically beneficial," commented Alexander Merkler, MD, MS, neurologist at Weill Cornell Medicine in New York City.

Bleeds represented in MIND were mostly deep (70.8%), otherwise lobar (29.2%). The deep bleeds tended to affect younger patients, more men, and people with more comorbidities; they were also associated with more severe stroke symptoms and smaller ICH volumes at presentation.

Merkler told MedPage Today that "given the safety and efficacy of hematoma evacuation, I look forward to future studies perhaps targeting earlier hematoma evacuation as a means to improve outcomes."

MIND was a prospective, open-label trial that enrolled adults up to 80 years old with moderate-large (20-80 mL) supratentorial ICH, presenting within 24 hours of symptom onset, with an NIH Stroke Scale score of at least 6, and who had previously been living with no or minimal disability.

Participants were randomized 2:1 to MIS or medical management alone of their brain bleeds. The MIS patients had their procedures within 72 hours of the ictus/bleed.

Fiorella explained that MIND had started with 200 patients and passed an interim analysis before the data threw clinical equipoise into question. Investigators eventually stopped randomizing lobar ICHs, and enrollment paused due to a protocol amendment. Later, an independent feasibility analysis suggested low probability of statistical difference between study arms in the deep ICH cohort. In the end, the group had a final sample of 236 individuals -- too few for a powered analysis of the primary endpoint.

Participants had a median age of 60 years, and under 40% were women. NIH Stroke Scale score was 18 at baseline. Time to randomization was 19.5 hours for the control group and 22 hours for the MIS group. Baseline ICH volume was around 40 mL. Hemphill scores were about 80% in the 0-2 range, and GCS scores about 55% in the 5-12 range.

Subgroup comparisons did not show that MIS resulted in any better or worse survival in deep or lobar brain bleeds.

Yet serious adverse events -- particularly symptomatic evolution of perihematomal edema -- were less frequent in the MIS arm compared with medical management, a finding that was consistent between the two ICH locations.

Stays in the hospital and ICU were about equally long whether patients received MIS or not. Only the secondary endpoint of intubation at 30 days appeared to favor MIS (3.6% vs 12.1%, P=0.047).

• 

  Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

Disclosures

The study was sponsored by Penumbra.

Fiorella disclosed relationships with Medtronic, Stryker, BALT USA, Cerenovus, RAPID.ai, RAPID Medical, Q'Apel, Phenox, MENTICE, Microvention, Scientia, Arsenal, and Elixir.

Merkler had no disclosures.

Primary Source

International Stroke Conference

Source Reference: Fiorella D "Procedural, safety, and functional outcomes following minimally invasive surgery for deep and lobar intracranial hemorrhages: 180-day MIND study results" ISC 2025.

Rehabilitation of Upper Limb Motor Impairment in Stroke: A Narrative Review on the Prevalence, Risk Factors, and Economic Statistics of Stroke and State of the Art Therapies

 One sentence could describe the complete failure of stroke rehab.  NOTHING RIGHT NOW WILL GET YOU FULLY RECOVERED! Stroke is a complete shitshow of failure!

This proves the complete failure:

1. tPA full recovery? Better than 12%?
2. rehab full recovery? Better than 10%?

Rehabilitation of Upper Limb Motor Impairment in Stroke: A Narrative Review on the Prevalence, Risk Factors, and Economic Statistics of Stroke and State of the Art Therapies

Saba Anwer 1 , Asim Waris 1 , Syed Omer Gilani 1 , Javaid Iqbal 1 , Nusratnaaz Shaikh 2 , Amit N. Pujari 3,4 and Imran Khan Niazi 2,5,6, * 1 School of Mechanical & Manufacturing Engineering, National University of Sciences and Technology (NUST), Islamabad 45200, Pakistan; sanwer.bmes19smme@student.nust.edu.pk (S.A.); asim.waris@smme.nust.edu.pk (A.W.); omer@smme.nust.edu.pk (S.O.G.); j.iqbal@ceme.nust.edu.pk (J.I.) 2 Faculty of Health & Environmental Sciences, Health & Rehabilitation Research Institute, AUT University, Auckland 0627, New Zealand; nusrat.shaikh@aut.ac.nz 3 School of Physics, Engineering and Computer Science, University of Hertfordshire, Hatfield AL10 9AB, UK; amit.pujari@ieee.org 4 School of Engineering, University of Aberdeen, Aberdeen AB24 3FX, UK 5 Center of Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand 6 Center for Sensory-Motor Interaction, Department of Health Science & Technology, Aalborg University, 9000 Alborg, Denmark * Correspondence: imran.niazi@nzchiro.co.nz 

Abstract: 

Stroke has been one of the leading causes of disability worldwide and is still a social health issue. Keeping in view the importance of physical rehabilitation of stroke patients, an analytical review has been compiled in which different therapies have been reviewed for their effectiveness, such as functional electric stimulation (FES), noninvasive brain stimulation (NIBS) including transcranial direct current stimulation (t-DCS) and transcranial magnetic stimulation (t-MS), invasive epidural cortical stimulation, virtual reality (VR) rehabilitation, task-oriented therapy, robot-assisted training, tele rehabilitation, and cerebral plasticity for the rehabilitation of upper extremity motor impairment. New therapeutic rehabilitation techniques are also being investigated, such as VR. This literature review mainly focuses on the randomized controlled studies, reviews, and statistical meta-analyses associated with motor rehabilitation after stroke. Moreover, with the increasing prevalence rate and the adverse socio-economic consequences of stroke, a statistical analysis covering its economic factors such as treatment, medication and post-stroke care services, and risk factors (modifiable and non-modifiable) have also been discussed. This review suggests that if the prevalence rate of the disease remains persistent, a considerable increase in the stroke population is expected by 2025, causing a substantial economic burden on society, as the survival rate of stroke is high compared to other diseases. Compared to all the other therapies, VR has now emerged as the modern approach towards rehabilitation motor activity of impaired limbs. A range of randomized controlled studies and experimental trials were reviewed to analyse the effectiveness of VR as a rehabilitative treatment with considerable satisfactory results. However, more clinical controlled trials are required to establish a strong evidence base for VR to be widely accepted as a preferred rehabilitation therapy for stroke.

Study estimates about a quarter of Indian population can access stroke facility in an hour

The solution is 100% recovery protocols! NOT more stroke centers! They are already complete failures: Why would you install more failures?

1. tPA full recovery? Better than 12%?
2. 30 day deaths? Better than competitors?
3. rehab full recovery? Better than 10%?

SOLVE THE PROBLEM FOR ALL STROKE SURVIVORS! Not just a tiny bandage over the gaping maw of failure that is the current stroke situation in India!

 Study estimates about a quarter of Indian population can access stroke facility in an hour 

Roughly a fourth of the Indian population has access to a rehabilitation centre within an hour of experiencing an ischaemic stroke -- caused when a blood clot affects supply to the brain, a study has found. The research, published in the International Journal of Stroke, also estimated that there is less than one ischaemic stroke centre per million population.

Ischaemic stroke is the most common, accounting for about 70-80 per cent of all strokes in India, according to a September 2024 study, published in the journal Scientific Reports.

In the recent study, researchers, including those from the US' Ascension Health and All India Institute of Medical Sciences (AIIMS), Hyderabad, found that a total of 566 stroke centres equipped with the 'intravenous thrombolysis method of treatment (which breaks up blood clots) were spread across 26 states and union territories.

Of the 566, over 60 per cent (361) were found to be also equipped with endovascular therapy for stroke patients, considered superior.

Typically, an ischaemic stroke patient was 115 kilometres away from the nearest intravenous thrombolysis treatment centre and about 130 kilometres away from the nearest endovascular therapy centre, the researchers found.

Further, a little over 26 per cent of the Indian population can access intravenous thrombolysis centre in under an hour, while about a fifth can access endovascular therapy centre, the team found.

For the analysis, data on "intravenous thrombolysis capable (IVT-C) and endovascular treatment capable (EVT-C)" stroke centres were collected in March 2021 from medical devices and pharmaceutical industry providers. Time taken to drive to the nearest stroke care centre was estimated using the application 'Google Distance Matrix API'.

"Access within one hour to an IVT-C and an EVT-C centre was available to 26.3 per cent and 20.6 per cent of the Indian population, respectively," the authors wrote.

"The average stroke centres per million (SCPM) population was 0.41 and 0.26 for IVT-C and EVT-C, respectively," they wrote.

Further, "median (typical) distances to the nearest IVT-C and EVT-C centres were 115 kilometres and 131 kilometres, respectively."

The authors said establishing stroke facilities equipped with intravenous thrombolysis and endovascular treatments in poorly served regions in India(Which won't get them 100% recovered! That is the only goal for all stroke survivors, if you would listen to their requirements!) is urgently needed to increase access and improve outcomes for stroke patients.

Roughly a fourth of the Indian population has access to a rehabilitation centre within an hour of experiencing an ischaemic stroke -- caused when a blood clot affects supply to the brain, a study has found. The research, published in the International Journal of Stroke, also estimated that there is less than one ischaemic stroke centre per million population.

Roughly a fourth of the Indian population has access to a rehabilitation centre within an hour of experiencing an ischaemic stroke -- caused when a blood clot affects supply to the brain, a study has found. The research, published in the International Journal of Stroke, also estimated that there is less than one ischaemic stroke centre per million population.

Roughly a fourth of the Indian population has access to a rehabilitation centre within an hour of experiencing an ischaemic stroke -- caused when a blood clot affects supply to the brain, a study has found. The research, published in the International Journal of Stroke, also estimated that there is less than one ischaemic stroke centre per million population.

St. Luke’s Health-The Vintage Recognized for Stoke Care; HOUSTON, TX

 

This is the whole problem in stroke enumerated in one word; 'care' NOT RECOVERY!

YOU have to get involved and chance this failure mindset of 'care' to 100% RECOVERY!

I wouldn't go there for stroke; they refer to 'care; NOT RECOVERY! Survivors want 100% recovery; this center does nothing of the sort! YOU are going to have to scream at them for not showing these three results:

There is no quality here if you don't measure the right things.

1. tPA full recovery? Better than 12%?
2. 30 day deaths? Better than competitors?
3. rehab full recovery? Better than 10%?

 

You'll want to know results so call that hospital president(whomever that is) RESULTS are; tPA efficacy, 30 day deaths, 100% recovery. Because there is no point in going to that hospital if they are not willing to publish results.

St. Luke’s Health-The Vintage Recognized for Stoke Care

HOUSTON, TX -- St. Luke’s Health-The Vintage Hospital has received certification from DNV as a Primary Stroke Center and designation as a Primary (Level III) Stroke Facility from the Texas Department of State Health Services (DSHS). These achievements affirm the hospital’s readiness to handle a full range of stroke-related medical problems.

“These recognitions let our community know that our hospital has the combination of the necessary equipment, expert staff and extensive training to provide the best possible stroke care," said Mario Garner, president of St. Luke’s-The Vintage. “Achieving certification from DNV and designation from DSHS validates the effort our teams have put into this program to ensure the health of our patients.”

The DNV Primary Stroke Center Certification is based on standards set forth by the Brain Attack Coalition and the American Stroke Association, and affirms that a hospital addresses the full spectrum of stroke care – diagnosis, treatment, rehabilitation and education – and establishes clear metrics to evaluate outcomes.

Hospitals designated as a Primary (Level III) Stroke Facility must meet the DSHS-approved national stroke standards of care for a Primary Stroke Center, participate in the hospital's Regional Advisory Council and regional stroke plan, and submit data to the department as requested.

According to the American Stroke Association, stroke is a leading cause of death, killing nearly 130,000 people each year, and is a leading cause of serious, long-term adult disability. Because stroke or “brain attack” affects blood flow to the brain, rapid and effective treatment can save lives and provide the best chance of limiting the extent of long-term damage.

Washington Regional Achieves Recertification as NWA’s Only Comprehensive Stroke Center

 I wouldn't go there for stroke; they refer to 'care; NOT RECOVERY! Survivors want 100% recovery; this center does nothing of the sort! YOU are going to have to scream at them for not showing these three results:

There is no quality here if you don't measure the right things.

1. tPA full recovery? Better than 12%?
2. 30 day deaths? Better than competitors?
3. rehab full recovery? Better than 10%?

 

You'll want to know results so call that hospital president(whomever that is) RESULTS are; tPA efficacy, 30 day deaths, 100% recovery. Because there is no point in going to that hospital if they are not willing to publish results.

Washington Regional Achieves Recertification as NWA’s Only Comprehensive Stroke Center

Washington Regional Medical Center has earned The Joint Commission’s Gold Seal of Approval® and the American Stroke Association’s Heart-Check mark for recertification as a Comprehensive Stroke Center. Washington Regional first achieved certification as a Comprehensive Stroke Center in 2019 and is the only Comprehensive Stroke Center in Northwest Arkansas. The prestigious designation means Washington Regional is prepared to treat even the most complex stroke cases with 24/7 in-person care(NOT RECOVERY!) from stroke experts.

“Stroke is a leading cause of death in the U.S. and in Arkansas. As a Joint Commission certified Comprehensive Stroke Center, Washington Regional provides patients with advanced treatments so they can receive the care(NOT RECOVERY!) they need without having to leave Northwest Arkansas,” says Washington Regional President and CEO Larry Shackelford. “Every minute counts during a stroke, and getting to the right place quickly for care(NOT RECOVERY!) is critical. As a Comprehensive Stroke Center, Washington Regional offers the best chance of survival and recovery with minimally invasive stroke treatment options, advanced neurosurgical care(NOT RECOVERY!), advanced imaging capabilities and the area’s only neurosurgical intensive care(NOT RECOVERY!) unit.”

“Comprehensive Stroke Center Certification recognizes health care organizations committed to striving for excellence and fostering continuous improvement in patient safety and quality of care(NOT RECOVERY!)” says Ken Grubbs, DNP, MBA, RN, executive vice president of Accreditation and Certification Operations and chief nursing officer, The Joint Commission. “We commend Washington Regional for using The Joint Commission certification process to reduce variation in clinical processes and to strengthen its clinical program to drive safer, higher quality and more compassionate care(NOT RECOVERY!) for individuals served.”

“We congratulate Washington Regional for this outstanding achievement,” says Nancy Brown, chief executive officer, the American Stroke Association. “This certification reflects its commitment to providing the highest quality of care(NOT RECOVERY!) for stroke patients.”

To achieve recertification, Washington Regional’s Stroke Program, part of the Washington Regional J.B. Hunt Transport Services Neuroscience Institute, underwent a rigorous onsite review in September. During the visit, a team of Joint Commission reviewers evaluated compliance with certification standards and conducted onsite observations and interviews. The Joint Commission is the nation’s oldest standards-setting and accrediting body in health care(NOT RECOVERY!).

AI Twice as Accurate at Pinpointing Stroke Time Than Current Methods – Study

 But you still have nothing that will stop the 5 causes of the neuronal cascade of death in the first week thus killing off millions to billions of neurons!

Time is not the problem; it's that you have NOTHING TO GET SURVIVORS 100% RECOVERED!

AI Twice as Accurate at Pinpointing Stroke Time Than Current Methods – Study

Artificial intelligence could be twice as accurate as current methods at pinpointing the time a stroke took place, which could help medics make emergency decisions about care, according to a study.

Using the technology to read the brain scans of people who have had strokes could allow up to 50% more patients to be treated appropriately, researchers suggested.

The team behind the software claim it is twice as accurate as current methods, which involve doctors visually assessing a scan to make treatment decisions.

Developers hope the model will eventually be used in the health service and could potentially be integrated with AI-analytic software already being used by NHS trusts.

The algorithm was created by researchers at Imperial College London, Technical University of Munich and Edinburgh University.

It was trained using 800 brain scans where the time of stroke was known and then tested on 2000 patients.

The study found the model was twice as accurate as the visual method, which researchers suggest could be due to the fact it takes in additional features from scans, such as texture.

Patients who go to hospital with suspected stroke are given a CT scan to determine the cause and severity, within an hour where possible.

Doctors then review the results and make decisions on treatment, in which time is an important factor.

Thrombolysis, a process that uses drugs to break up blood clots, can be performed within four and a half hours of symptoms starting.(And that only gets you to tPA full recovery of only 12%; WHICH IS A MASSIVE FAILURE!)

A thrombectomy – when doctors surgically remove a blood clot to restore blood flow – is most effective six hours after symptoms start, although it can be performed for up to 24 hours in rare cases.

Dr Paul Bentley, of Imperial’s Department of Brain Sciences, and a consultant neurologist at Imperial College Healthcare NHS Trust, led the study which is published in NPJ Digital Medicine.

He said: “It’s essential for doctors to know both the initial onset time, as well as whether a stroke could be reversed.

“Having this information at their fingertips will help doctors to make emergency decisions about what treatments should be undertaken in stroke patients.

“Not only is our software twice as accurate at time reading as current best practice, but it can be fully automated once a stroke becomes visible on a scan.”

Lead author Dr Adam Marcus added: “We estimate that up to 50% more stroke patients could be treated appropriately with treatments because of our method.(But those treatment methods are a failure at getting to 100% recovery! 

When these persons become the 1 in 4 per WHO that has a stroke : they'll want 100% recovery and by then it will be too late.)

“We aim to deploy our software in the NHS, possibly by integrating with existing AI-analytic software that is already in use in hospital trusts.”

These vascular risks are strongly associated with severe stroke, researchers say

 This is just used as a distraction from their COMPLETE FAILURE TO GET SURVIVORS 100% RECOVERED!

Recovery statistics here; a complete failure by any measure!

Here's your 100% recovery failure statistics!

tPA full recovery is only 12%

Only 10% get to full recovery.

The latest here:

These vascular risks are strongly associated with severe stroke, researchers say

             Many risk factors can lead to a stroke, but the magnitude of risk from some of these conditions or behaviors may have a stronger association with severe stroke compared with mild stroke, according to a new study.

Stroke is the third leading cause of death around the world, according to a November 2018 study, causing around 5.5 million deaths annually.

Related article Updated guidelines may help reduce the risk of a first-time stroke, according to the American Stroke Association

“A stroke occurs when the central nervous system is injured due to a vascular cause, so that could be due to a blockage, which accounts for about 80% of strokes in the United States, or a ruptured blood vessel, which is a hemorrhage, and that’s 20% of strokes in the United States,” said Dr. Steve Messe, professor of neurology at the University of Pennsylvania, who wasn’t involved in the study.

Some risks associated with stroke are hypertension (high blood pressure), atrial fibrillation (an irregular heartbeat) and smoking, according to the US Centers for Disease Control and Prevention.

The study, which published Wednesday in the journal Neurology, revisited data collected between 2007 and 2015 as part of the INTERSTROKE study. Patients were recruited from 142 centers in 32 countries and given standardized questionnaires to measure risk factors, according to the study.

Researchers observed 13,460 patients with stroke and divided the cases based on whether they suffered from a severe or non-severe stroke, which they categorized using a six-point scale that measures a patient’s degree of disability.

“This study looked at the association between modifiable risk factors with severe and mild-moderate stroke. Three risk factors — high blood pressure, smoking and atrial fibrillation (which is an irregular heart rhythm) were linked with higher risk of severe compared to mild-moderate stroke,” said Dr. Catriona Reddin, the first study author, via email. “This emphasises the importance of managing these risk factors, along with other risk factors of stroke.”

Maintain a healthy lifestyle by following a balanced diet, exercising regularly, avoiding smoking and managing blood pressure, said first study author Dr. Catriona Reddin of University Hospital Galway

FG Trade/E+/Getty Images

Prior research has linked obesity, high blood pressure and elevated cholesterol to strokes, which is consistent with this new study’s findings.

“Our study highlights that some risk factors are particularly important for severe stroke. We hope that hearing the results of our study may emphasise the importance of managing risk factors of stroke,” said Reddin, geriatric medicine specialist registrar at University Hospital Galway and research fellow at University of Galway in Ireland.

Are you at risk of a stroke?

High blood pressure is a risk that most people underestimate, and since 50% of Americans have high blood pressure, it’s an important risk factor to consider, said Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, who wasn’t involved in the study. (Freeman is also a medical adviser for WeWard, an activity-tracking app that also incentivizes users to move by letting them accrue points they can redeem for prizes or charity donations. He hasn’t received any financial compensation.)

High blood pressure, also known as hypertension, can result from an unhealthy lifestyle or certain health conditions, such as diabetes or obesity. The condition can also occur during pregnancy.

Related article This non-medical intervention may reduce your stroke risk

Hypertension can damage your heart’s tissue and conduction system, leading to atrial fibrillation, or an irregular heartbeat, according to the Cleveland Clinic.

Smoking is strongly associated with cardiovascular disease and can cause the blood to clot and block blood flow to the heart and brain.

“It’s not just tobacco smoke, but marijuana smoke or even really bad air pollution can significantly lead to increased vascular events and risks,” Freeman said.

How to prevent a stroke

Focusing on eating plants, exercising more, stressing less, loving more and sleeping enough can help you lower the risk of stroke, according to Freeman.

Reducing salt in your diet, avoiding high-cholesterol foods, and eating fresh fruits and vegetables can help to lower blood pressure.

Keeping active can also lower blood pressure and help you maintain a healthy weight. In fact, people who are more active have a 25% to 30% lower risk of stroke than the least active people, according to the American Heart Association.

Exercise has also been found to reduce the negative effects of stress, including spikes in blood pressure, by boosting the production of endorphins.

Related article Stroke presents differently in women than men. Here are 7 symptoms to look for

However, if you suspect that you or someone around you is having a stroke, immediately call 911 and get to an ER as soon as possible, Messe said. Stroke treatment is time-sensitive, so it’s important to move quickly.

How to spot signs someone is having a stroke

What do you think? Join 9 others in the comments

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You can use the acronym FAST to spot the warning signs of a stroke, according to the American Heart Association.

· Face: Smile. Does one side of your face droop?

· Arms: If you raise both arms, does one arm drift down?

· Speech: Are you having difficulty speaking? Is your speech slurred?

· Time: If you see any of these signs, call 911 immediately.

9 comments

Michigan fan saved after wife recognizes stroke at football game

A total outlier. Don't expect this to happen to you, I got tPA in 90  minutes and that wasn't fast enough for full recovery and since nothing was done to stop the 5 causes of the neuronal cascade of death in the first week thus letting hundreds of millions to billions of neurons die!

In this research in mice the needed time frame for tPA delivery is 3 minutes for full recovery. Electrical 'storms' and 'flash floods' drown the brain after a stroke If your hospital can't do that, what is their EXACT backup plan to get you 100% recovered? You better ask them that now instead of hoping they can 'wing it' when you need it!

Here's your 100% recovery failure statistics!

tPA full recovery is only 12%

Only 10% get to full recovery.

The latest here:

 Michigan fan saved after wife recognizes stroke at football game

A fan who suffered a stroke while cheering at a University of Michigan football game is celebrating a full recovery thanks to a comprehensive response that began with his wife.

During the fourth quarter of the Wolverines’ Aug. 31 season opener against Fresno State, U-M star cornerback Will Johnson intercepted a pass for a touchdown to seal a victory.

As the crowd roared, Scott Everett, 60, stood to give another spectator a two-handed high five. The longtime resident of Portage, Mich., is a self-proclaimed diehard U-M fan who has attended nearly every home football game for the last decade.

Everett’s wife, Kathy, 58, noticed something wrong with the gesture.

Scott’s left hand started to drop.

“He hesitated, and it caught my eye,” she said. “I asked him what was wrong. He said, ‘I don’t know — nothing.’”

Kathy Everett recognized the limp arm and facial droop as telltale signs of stroke. She ran up the steps of Michigan Stadium and alerted staff to the emergency. 

Responders from the medical team, staffed by doctors from the U-M Health Department of Emergency Medicine’s EMS Division and paramedics and nurses from Huron Valley Ambulance, arrived to find that Scott could not stand without the support of his friends.

They placed him onto a stretcher before loading him into an ambulance. 

Everett’s symptoms started around 10:30 p.m., and he arrived at University of Michigan Health’s emergency department just after 11 p.m.

Imaging showed a clot in his brain’s middle cerebral artery, a major vessel that supplies blood to parts of the frontal, temporal and parietal lobes. It is the most common artery involved in acute ischemic stroke.

Stroke response

The health care team deemed Everett to be a candidate for the clot-busting medication Tenecteplase and thrombectomy, a minimally invasive procedure to remove the obstruction.

“Five years ago, these therapies were not widely available and this would have been a major disabling stroke,” said Tarun Singh, MBBS, a neurocritical care physician at University of Michigan Health who specializes in acute neurological diseases including stroke. 

“He likely would not have been able to eat, walk or remain independent. But the recognition and response were as fast as possible and got Mr. Everett here early enough to get these time-sensitive treatments.”

For every stroke, U-M Health Comprehensive Stroke Center activates a multidisciplinary response involving emergency medicine, neurology, neurointerventional radiology and neurosurgery.

Just after midnight, neurointerventionalist Zachary Wilseck, M.D., threaded a catheter from an artery in Scott Everett’s leg all the way to his brain to remove the clot.

“Even before being moved off the table, Mr. Everett was already demonstrating improving strength in his left arm and leg,” Wilseck said.

“The procedure went exactly as we’d hoped. All members of the team worked together to efficiently evaluate, diagnose and treat him.”

A life renewed

Twelve hours after the operation, Scott Everett was walking the hospital halls. He also talked about attending the next Michigan football game.

This came as a relief to Kathy Everett, who made the decision for the team to go through with the Tenecteplase and thrombectomy.

“I was a little hesitant at first as they described it until they said this is the best combination for him to have a full recovery,” she said.

“Scott is very athletic and on-the-go. The worst thing would be to not have him at all, but any form of paralysis would be very difficult for him.”

He continued with light walking after being discharged from the hospital on Sept. 3. The couple returned to the Big House to hugs and cheers from their tailgating friends the following weekend as U-M took on Texas.

Scott with his tailgating group at the U-M game after recovering from his stroke. Credit: Everett

Everett has continued to ramp up his physical activity. He regularly rides a stationary bike and has done some kayaking. True to their fandom, he and Kathy have not missed another U-M home game.

Still, the Everetts remain stunned by Scott’s stroke. None of his medical visits to his home providers indicated any risk for it. 

Which is why, Scott says, the ability to recognize the symptoms of stroke as quickly as his wife did is so essential. 

“We’ve been to so many football games and seen the medical team in action, which is always so impressive,” he said. “I was so active and felt somewhat invincible. As surprised as we were, it can happen to anyone. And I wouldn’t be here if it wasn’t for Kathy.” 

To identify signs of a stroke, remember the acronym B.E. F.A.S.T.:

• Balance issues

• Eyesight changes/vision loss

• Facial droop

• Arm weakness

• Speech difficulty

• Time to call 911 

Twenty Years of Sustained Improvement in Quality of Care and Outcomes for Patients Hospitalized With Stroke or Transient Ischemic Attack: Data From The Get With The Guidelines-Stroke Program

 THIS IS ABSOLUTELY APPALLING! Talking about 'care' instead of RECOVERY! Which is why I consider the AHA/ASA one of the fucking failures of stroke associations!

Not even measuring 100% recovery which is what every survivor wants!

Here's your 100% recovery failure statistics!

tPA full recovery is only 12%

Only 10% get to full recovery.

“What's measured, improves.” So said management legend and author Peter F. Drucker 

The latest crapola here:

Twenty Years of Sustained Improvement in Quality of Care and Outcomes for Patients Hospitalized With Stroke or Transient Ischemic Attack: Data From The Get With The Guidelines-Stroke Program

Ying Xian, MD, PhD https://orcid.org/0000-0002-1237-1162, Shen Li, MS https://orcid.org/0000-0001-9322-6516, Tian Jiang, MS, Chandler D. Beon, BA https://orcid.org/0000-0001-6868-0370, Remy Poudel, MPH https://orcid.org/0009-0008-2028-8773, Kathie Thomas, DHA, MPH https://orcid.org/0009-0006-1692-3282, Mathew J. Reeves, PhD https://orcid.org/0000-0002-8019-6343, … Show All … , and Gregg C. Fonarow, MD https://orcid.org/0000-0002-3192-8093 gfonarow@mednet.ucla.eduAuthor Info & Affiliations

Stroke

New online

https://doi.org/10.1161/STROKEAHA.124.048174

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Abstract

BACKGROUND:

The Get With The Guidelines-Stroke program is a quality improvement initiative designed to enhance adherence to evidence-based stroke care(NOT RECOVERY!). Since its inception in 2003, over 2800 hospitals in the United States have participated in the program.

METHODS:

We examined patient characteristics, adherence to performance measures, and in-hospital outcomes in patients hospitalized for acute ischemic stroke, subarachnoid hemorrhage, intracerebral hemorrhage, and transient ischemic attack in The Get With The Guidelines-Stroke hospitals from 2003 through 2022. We quantified temporal changes in performance measure adherence and clinical outcomes over time. Performance measure denominators consisted of patients who were eligible, excluding those with contraindications.

RESULTS:

Over the 20 years of the program, a total of 7837 849 stroke cases (median age 71 years, 51.0% female; 69.2% ischemic strokes, 3.9% SAHs, 11.5% ICHs, and 15.3% TIAs) were entered into the registry. Except for antithrombotics at discharge, in which the baseline performance was >92%, there was sustained improvement in all performance metrics regardless of type of cerebrovascular event (P<0.01 for all). In patients with acute ischemic stroke, large improvements were observed for anticoagulation for atrial fibrillation (55.7% in 2003 to 97.2% in 2022), smoking cessation counseling (44.7%–97.8%), dysphagia screening (53.8%–83.5%), thrombolytic treatment for patients arriving by 3.5 hours, treat by 4.5 hours (15.2%–92.9%), door-to-needle time within 60 minutes (19.0%–75.3%), and endovascular door-to-puncture time within 90 minutes (54.7%–62.8%). Similar improvements were also observed for measures relevant to patients with subarachnoid hemorrhage, intracerebral hemorrhage, and transient ischemic attack. Multivariable analysis showed that there was a sustained increase in odds of receiving each performance measure over time, independent of patient and hospital characteristics for each type of cerebrovascular event. After risk adjustment, there were temporal trends that patients were less likely to be discharged to a skilled nursing facility, and, for ischemic stroke only, more likely to be discharged directly home.

CONCLUSIONS:

During the first 20 years, Get With The Guidelines-Stroke participation was associated with sustained improvement in evidence-based care(NOT RECOVERY!) and outcomes for patients with stroke and transient ischemic attack in the United States.

Graphical Abstract

Stroke patients face seven-hour waits for specialist care

 Which means your stroke hospital still has to to have 100% recovery protocols regardless of entry time. NO EXCUSES ALLOWED. Leaders prepare and deliver on challenges! Even getting them there in 4 hours is not enough; tPA full recovery is only 12% so your doctor and hospital still haveto have  protocols needed for 100% recovery post tPA or brain bleed stoppage.

 Stroke patients face seven-hour waits for specialist care

Waiting times for stroke patients have doubled, with average delays of seven hours for specialist care, official data show.

NHS England guidance states that every patient with acute stroke should be given access(NOT GOOD ENOUGH! Survivors still want full recovery! Don't shrink from your responsibility.) to a stroke unit within four hours.

The timeframe is considered critical because patients can be given only clot-busting drugs and treatments such as thrombectomy, which surgically removes a clot, within the first few hours of stroke onset.

But the figures for 2022-23 show it being hit in just four in 10 cases. Overall, patients in England were waiting an average of six hours 49 minutes to be admitted to a specialist unit in 2022-23, compared to three hours 32 minutes in 2019-20.

The analysis of NHS data by the Health Service Journal found University Hospitals Sussex had the longest average waits last year, of more than 14 hours, with just eight per cent of patients seen within four hours.

The trust said the service had since moved into a new £500 million hospital in Brighton which was helping to speed up care through an acute stroke assessment area.

Some trusts said ambulance handover delays appeared to be fuelling waiting times. Many of the worst-affected units were in areas with significant handover delay problems, particularly the South West.

The figures are for 2022-23, when many parts of the country saw the worst ambulance handover delays on record. But recent weeks have seen several areas with long delays.

Just before Christmas, the heads of the NHS trusts with the worst ambulance queues were hauled in front of Victoria Attkins, the Health Secretary, and ordered to “buck up their ideas”.

Juliet Bouverie, the chief executive of the Stroke Association, called for urgent action to tackle the problem, saying: “Stroke is a medical emergency and every minute is critical.

“We are very concerned to see that, far from improving over the past year, the proportion of stroke patients being admitted to a stroke ward within the timescale for thrombolysis has continued to decline. This is putting patient recoveries at risk and strain on the rest of the health system.”

She said stroke units needed more support from community teams to free up beds, with an expansion in the workforce for stroke care needed.

NHS England cited record demand for emergency care, adding that response times for category two 999 calls have improved since last year.

A spokesman for NHS England said: “Thanks to ongoing improvements in NHS stroke care, more people than ever are surviving a stroke.

“The NHS is committed to delivering the highest-quality stroke services possible by increasing the speed that people are seen and treated and increasing the number of patients accessing thrombectomy, thrombolysis and stroke rehabilitation.”