Current Developments in Stroke

Author(s): Jeyaraj D. Pandian, Akanksha G. William, Peter Langhorne and Richard Lindley

DOI: 10.2174/9781681085241116020007

Stroke Care: Stroke Units, New Therapies, Advances and the Future

Pp: 81-97 (17)

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Abstract

SHS investigation development is considered from the geographical and historical viewpoint. 3 stages are described. Within Stage 1 the work was carried out in the Department of the Institute of Chemical Physics in Chernogolovka where the scientific discovery had been made. At Stage 2 the interest to SHS arose in different cities and towns of the former USSR. Within Stage 3 SHS entered the international scene. Now SHS processes and products are being studied in more than 50 countries.

Abstract

Thrombolysis (clot dissolving using medicine) and thrombectomy (clot removal via minimally invasive angiogram) are effective acute treatments for ischaemic stroke, but are expensive and time limited. Specialized stroke units are proven to manage stroke-related sequelae and complications effectively. They make stroke treatment quicker, easier and more accessible for a larger number of patients and have specialized staff, predefined protocols and better rehabilitation outcomes. These stroke units have proven benefits in countries that can afford them, but should be extended even to limited-resource settings when possible. Besides thrombolysis, thrombectomy and stroke unit care, ongoing research is exploring medications that may keep brain tissue in the region of a stroke alive for longer (cytoprotection), technological advances such as nanoparticles to increase the penetration of thrombolytic agents into the clot and stem cell therapies, all of which remain to be proven in large-scale randomized controlled trials. As a significant number of patients live with some level of disability, rehabilitation is important. Newer techniques to augment traditional rehabilitation such as robots and computer-based systems and virtual rehabilitation are some of the options currently being actively studied. These are easy to use and have shown positive results in small scale studies, but may be costly.

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