Update on Stroke Diagnosis and Treatment

Papers dealing with the diagnosis and treatment of stroke patients were presented at the 27th International Conference of the American Stroke Association (ASA) in Dallas (TX, USA). Some highlights follow.


Training aids diagnosis
Emergency doctors need training in the use of computed tomography (CT) to diagnose stroke. Researchers found that one hour of structured teaching allowed emergency doctors to dramatically improve their ability to read a CT scan. After 45 days, a test found that hemorrhagic stroke was correctly identified in 68% of the cases by doctors prior to training, in 100% of the cases after the training, and in 100% of the cases 45 days after training.

Neck manipulation a cause
Chiropractic manipulation of the neck may be underestimated as a cause of stroke, especially in young women. Statistics from an ongoing study indicate that 20% of strokes are due to neck manipulation. Also, according to the researchers, patients with Marfan's syndrome may be more vulnerable to this kind of trauma-related injury to their fragile arteries.

Hyperglycemia affects outcome
Animal and human studies indicates that high blood sugar during stroke is associated with larger areas of brain-damaged tissue and a poor prognosis. In a new study, researchers analyzed the outcomes of patients who had hyperglycemia before receiving thrombolysis. They found that patients who have hyperglycemia before receiving tissue plasminogen activator (tPA) have a greater risk of death, and those who survive recover less, compared to patients with normal glucose.

Viagra aids recovery
Researchers induced ischemic stroke in rats, then administered sildenafil citrate (Viagra) orally for six days. The rats showed significantly improved recovery of neurologic function. Subsequent research found that Viagra given one day after stroke substantially reduced function deficits. The researchers conclude that Viagra promotes changes in the brain that contribute to the restoration of function.

Social support affects outcome
Data from a stroke study show that the biggest indicators for predicting a second stroke are the number of friends a patient has and whether the patient receives in-home help. Stroke patients with fewer than three friends are 40% more likely to suffer a second event. If they have no in-home help, they are 80% more likely to suffer a second stroke. Social support remained the leading risk indicator even when compared to high blood pressure, diabetes, education, gender, insurance, occupation, marital status, and the presence of a primary care doctor.




Related Links:
American Stroke