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In a review article in the journal MedLink Neurology, first author Murray Flaster, MD, PhD and colleagues summarize thelatest research on caring for ischemic stroke patients. (Moststrokes are ischemic, meaning they are caused by blood clots.) "The period immediately following an acute ischemic stroke isa time of significant risk," the Loyola neurologists write."Meticulous attention to the care of the stroke patient duringthis time can prevent further neurologic injury and minimize commoncomplications, optimizing the chance of functional recovery." Stroke care has two main objectives -- minimizing injury to braintissue and preventing and treating the many neurologic and medicalcomplications that can occur just after a stroke. The authors discuss the many complex factors that affect outcomes.For example, there is considerable evidence of a link betweenhyperglycemia (high blood sugar) and poor outcomes after stroke.The authors recommend strict blood sugar control, using frequentfinger-stick glucose checks and aggressive insulin treatment. For each 1 degree C increase in the body temperature of strokepatients, the risk of death or severe disability more than doubles.Therapeutic cooling has been shown to help cardiac arrest patients,and clinical trials are underway to determine whether such coolingcould also help stroke patients. Until those trials are completed,the goal should be to keep normal temperatures (between 95.9 and99.5 degrees F). Position in bed also is important, because sitting uprightdecreases blood flow in the brain. A common practice is to keep thepatient lying flat for 24 hours. If a patient has orthopnea(difficulty breathing while lying flat), the head of the bed shouldbe kept at the lowest elevation the patient can tolerate. The authors discuss many other issues in stroke care, includingblood pressure management; blood volume; statin therapy; managementof complications such as pneumonia and sepsis; heart attack andother cardiac problems; blood clots; infection; malnutrition andaspiration; brain swelling; seizures; recurrent stroke; and brainhemorrhages. Studies have shown that hospital units that specialize in strokecare decrease mortality, increase the likelihood of beingdischarged to home and improve functional status and quality oflife. All patients should receive supportive care -- including those whosuffer major strokes and the elderly. "Even in thesepopulations, the majority of patients will survive theirstroke," the authors write. "The degree of functionalrecovery, however, may be dramatically impacted by the intensityand appropriateness of supportive care." Co-authors are Loyolaneurologists and stroke specialists Sarkis Morales-Vidal, MD,Michael Schneck, MD, and Jose Biller, MD. I am an expert from grocerystoreshelves.com, while we provides the quality product, such as Supermarket Shopping Carts , Vegetable Display Stands Manufacturer, Custom Made Book Shelves,and more.
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