 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
Looking For Clues To Lazarus-Like Recoveries
UPI Correspondent Washington (UPI) Feb 09, 2007 The stroke patient arrived at the Ohio State Medical Center comatose and was rushed to the radiology department where doctors identified a clot in his vertebrobasilar artery system -- an often devastating condition. Gregory Christoforidis, an interventional radiologist and associate professor of neurology, began a catheter-based treatment that pushed clot-busting drugs directly into the blockage, dissolving the clot. When anesthesia was discontinued, the patient opened his eyes and was ready to get off the operating table -- an example of the "Lazarus phenomenon," Christoforidis recounted at the annual International Stroke Conference in San Francisco. "The only thing keeping him down was the effects of the anesthesia," said Christoforidis, who presented research on the types of stroke patients who have the potential to make rapid improvement in their condition -- especially after treatment with tissue plasminogen activator, also known as tPA, a clot-busting agent. The Lazarus phenomenon is named after Lazarus, who, according to the New Testament, was raised from the dead by Jesus. In his study, Christoforidis defined patients exhibiting the Lazarus phenomenon as those who were able to improve their National Institute of Health Stroke Scale score by more than 50 percent within 24 hours. In the case of the man with the basilar stroke, the only long-term deficit was a problem with double vision, Christoforidis told United Press International. He said that generally, patients who achieved that improvement so quickly were: -- Treated rapidly after their first stroke symptoms, within three hours of the onset of the signs of stroke. -- Had blood flow to the brain -- reperfusion -- restored to the area affected by the stroke. -- Exhibited on imaging scans a generous proportion of pial collaterals -- very small blood vessels that appear to supply the brain with nourishment in situations where larger and more important arteries are compromised by clots. With basilar-artery blockages, the entire brain is at risk and patients frequently die from this form of brain attack, Christoforidis said. With other strokes that occur in the middle cerebral artery, the anterior cerebral artery or the internal carotid artery in the brain, damage can be extensive, but patients can survive. He said that he has had Lazarus-phenomenon patients who recover while they were on the operating table. These are patients who may have come into the hospital with a leg that is paralyzed by the stroke. "Sometimes, we dissolve the stroke and they start moving their legs," Christoforidis said, causing problems when removing the catheters. The intra-arterial clot-busting procedure requires doctors to make a small incision in the groin in order to gain access to the arteries in the leg. The catheter is inserted into the artery and, under X-ray guidance, is advanced into the carotid artery in the neck. From there, a micro-catheter is snaked through the brain's arterial system until it reaches the clot. The tPA is then introduced directly into the clot, dissolving it, and allowing for blood flow -- reperfusion -- to occur. Of 108 patients in his study, Christoforidis said 26 exhibited the Lazarus phenomenon. Nearly 80 percent of those patients had the (recovery) scores; 45 percent of the patients achieved optimal reperfusion flow after the clot was opened; more than half of the patients were treated within three hours; almost 90 percent were treated within four and a half hours. "The lesson of this study is that these rapid improvements are possible in stroke patients, but it points out the importance of bringing the patient to the hospital as soon as possible," Christoforidis said. "An hour is very important." Because there is no control group in the work, Brian Silver, senior staff neurologist at Henry Ford Hospital and assistant professor clinician/educator at Wayne State University in Detroit, told UPI that it is uncertain that it is necessary to use the catheter-based system to produce "Lazarus-like" results. "The most important element is time," he said. "If we can get the patient to the hospital in an hour and start intravenous tPA, we get results similar to what Dr. Christoforidis is seeing." Silver said that a prospective clinical trial to answer the question of which procedure is better is ongoing. But, he said, whichever procedure is used -- and even in a few cases in which the patient gets no treatment -- doctors have witnessed Lazarus phenomenon outcomes.
Source: United Press International Related Links Hospital and Medical News at InternDaily.com Hospital and Medical News at InternDaily.com
Bones In Motion: Brown Scientists To Create New 3-D X-ray System
Providence RI (SPX) Feb 08, 2007Brown University researchers are creating a technology that will allow doctors and scientists to do the seemingly impossible: See inside living humans and animals and watch their bones move in 3-D as they run, fly, jump, swim and slither. This high-resolution, high-speed imaging system will contribute to better treatments for knee, shoulder, wrist and back injuries and help scientists understand the evolution of complex movements, from the flight of birds to the leap of frogs. |
|
|
| The content herein, unless otherwise known to be public domain, are Copyright Space.TV Corporation. AFP and UPI Wire Stories are copyright Agence France-Presse and United Press International. ESA Portal Reports are copyright European Space Agency. All NASA sourced material is public domain. Additional copyrights may apply in whole or part to other bona fide parties. Advertising does not imply endorsement, agreement or approval of any opinions, statements or information provided by Space.TV Corp on any Web page published or hosted by Space.TV Corp. Privacy Statement |
