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Spasticity after stroke: Will my hand get better?

Spasticity after stroke: Will my hand get better?

This article first appeared on arni.uk.com 
Written by Tom Balchin

Upper limb spasticity is suffered by a full 70% of the stroke population, By three months post stroke 19% of people will experience spasticity and this figure increases to 38% of people after 12 months.

Did you know that it’s one of the biggest things that survivors tell consultants, GPs, family, carers and friends that they wish they could positively alter?

Spasticity can develops months or even a year after stroke — and often may become more noticeable as recovery moves on and can have a very significant bearing on your quality of life. Let’s look at what spasticity is:

Muscle stiffness;
Upper extremity hypertonia (excessive muscle activity);
Loss of fine motor control (for example small hand movements);
Paresis;
Soft tissue contracture;
Muscle overactivity leading to the reduced ability to relax;
Muscle spasms;
Changes in limb posture; and
Muscle fatigue.

Let’s see if you can grab some tips here to help you beat its limitations.

Spasticity is caused by miscommunication between your brain and your muscles. It has neural and non-neural components to it. Let’s delve deeper: knowledge is power,

Normally your muscles are in constant communication with your brain about how much tension they’re feeling, and the brain has to constantly monitor this tension to prevent tearing. Your brain continuously sends out messages telling your muscles when to contract and relax.

You can read the full article here.

Testosterone replacement therapy (TRT) can increase men’s risk of stroke and heart attack

Testosterone replacement therapy (TRT) can increase men’s risk of stroke and heart attack

First published on ScienceDaily.com

Aging men with low testosterone levels who take testosterone replacement therapy (TRT) are at a slightly greater risk of experiencing an ischemic stroke, transient ischemic attack (TIA), or myocardial infarction, especially during the first two years of use, reports a study appearing in The American Journal of Medicine, published by Elsevier. The findings confirm concerns voiced by many health agencies about the potential risks associated with the treatment.

The study analyzed a large database of electronic medical records of patients enrolled in primary care practices in the United Kingdom and formed a cohort of 15,401 men, aged 45 years or older, with low testosterone levels (hypogonadism). Users of TRT had a 21 percent greater risk of cardiovascular events compared with nonusers, corresponding to an additional 128 events. The increased risk appears to be transient, declining after two years of TRT use, which the investigators attribute to a phenomenon called “depletion of susceptibles.”

“Our findings show that the use of TRT was associated with an increased risk of stroke, TIAs, or cardiac arrest during the first two years of use,” noted Christel Renoux, MD, PhD, Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital; and Departments of Epidemiology, Biostatistics, and Occupational Health, and Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada. “There is limited evidence on the long-term clinical benefits of TRT to effectively treat the modestly declining levels of endogenous testosterone levels of aging but healthy men. We strongly recommend that clinicians proceed with caution when considering prescribing TRT and first discuss both the potential benefits and risks with patients.”

Please read the full article here.

New technology improves atrial fibrillation detection after stroke

New technology improves atrial fibrillation detection after stroke

First published on ScienceDaily.com

A new method of evaluating irregular heartbeats outperformed the approach that’s currently used widely in stroke units to detect instances of atrial fibrillation.

The technology, called electrocardiomatrix, goes further than standard cardiac telemetry by examining large amounts of telemetry data in a way that’s so detailed it’s impractical for individual clinicians to attempt.

Co-inventor Jimo Borjigin, Ph.D., recently published the latest results from her electrocardiomatrix technology in Stroke. Among stroke patients with usable data (260 of 265), electrocardiomatrix was highly accurate in identifying those with Afib.

“We validated the use of our technology in a clinical setting, finding the electrocardiomatrix was an accurate method to determine whether a stroke survivor had an Afib,” says Borjigin, an associate professor of neurology and molecular and integrative physiology at Michigan Medicine.

A crucial metric

After a stroke, neurologists are tasked with identifying which risk factors may have contributed in order to do everything possible to prevent another event.

That makes detecting irregular heartbeat an urgent concern for these patients, explains first author Devin Brown, M.D., professor of neurology and a stroke neurologist at Michigan Medicine.

“Atrial fibrillation is a very important and modifiable risk factor for stroke,” Brown says.

Importantly, the electrocardiomatrix identification method was highly accurate for the 212 patients who did not have a history of Afib, Borjigin says. She says this group is most clinically relevant, because of the importance of determining whether stroke patients have previously undetected Afib.

When a patient has Afib, their irregular heartbeat can lead to blood collecting in their heart, which can form a stroke-causing clot. Many different blood thinners are on the market today, making it easier for clinicians to get their patients on an anticoagulant they’ll take as directed.

Please read the full article here.

Urinary tract and other infections may trigger different kinds of stroke

Urinary tract and other infections may trigger different kinds of stroke

First published on ScienceDaily.com

Several infections have been identified as possible stroke triggers, with urinary tract infections showing the strongest link with ischemic stroke, according to new research in the American Heart Association’s journal Stroke.

Previous research examined infections as triggers of stroke, but were limited to the correlation of acute infections with ischemic stroke, a type of stroke caused by blocked blood vessels in the brain. This study considered a wider range of infections, and examined connections with two other types of stroke: intracerebral hemorrhage, which is caused by a ruptured blood vessel in the brain, and a type of stroke that results from bleeds in the inner lining of the brain, called subarachnoid hemorrhage.

“Healthcare providers need to be aware that stroke can be triggered by infections,” said Mandip Dhamoon, M.D., Dr.P.H., senior study author and associate professor of neurology at the Icahn School of Medicine at Mount Sinai in New York City. “Probing into the previous weeks or months of a patient’s life before the stroke can sometimes help to illuminate the possible causes of stroke if there was an infection during that time.”

The researchers used the New York State Inpatient Databases and Emergency Department Databases from 2006 to 2013, which record all inpatient and emergency department visits to community hospitals in New York state. Electronic health record codes were used to identify hospitalizations and emergency department visits for the three types of stroke and for infections; including skin, urinary tract, septicemia, abdominal and respiratory. Records for hospitalizations for infections were considered for 7, 14, 30, 60, 90, and 120 days prior to the stroke occurrence.

For ischemic stroke, the researchers found that every infection type was linked with an increased likelihood of this type of stroke. The strongest link was seen with urinary tract infection, which was showed more than three times the increased risk of ischemic stroke within 30 days of infection. For all infection types, the magnitude of stroke risk decreased as the time period before ischemic stroke occurred increased.

For intracerebral hemmorhage, the connections with occurrence was strongest for urinary tract infections, septicemia (blood infection) and respiratory infections. Respiratory infection was the only infection related to the occurrence of subarachnoid hemorrhage.

Please read the full article here.

Long work hours associated with increased risk of stroke

Long work hours associated with increased risk of stroke

First published on ScienceDaily.com

Working long hours for 10 years or more may be associated with stroke. People under age 50 had a higher risk of stroke when working long hours for a decade or more.

People who worked long hours had a higher risk of stroke, especially if they worked those hours for 10 years or more, according to new research in the American Heart Association’s journal Stroke.

Researchers reviewed data from CONSTANCES, a French population-based study group started in 2012, for information on age (18-69), sex, smoking and work hours derived from questionnaires from 143,592 participants. Cardiovascular risk factors and previous stroke occurrences were noted from separate medical interviews.

Researchers found:

overall 1,224 of the participants, suffered strokes;
29% or 42,542, reported working long hours;
10% or 14,481, reported working long hours for 10 years or more; and
participants working long hours had a 29% greater risk of stroke, and those working long hours for 10 years or more had a 45% greater risk of stroke.

Long work hours were defined as working more than 10 hours for at least 50 days per year. Part-time workers and those who suffered strokes before working long hours were excluded from the study.

“The association between 10 years of long work hours and stroke seemed stronger for people under the age of 50,” said study author Alexis Descatha, M.D., Ph.D., a researcher at Paris Hospital, Versailles and Angers University and at the French National Institute of Health and Medical Research (Inserm). “This was unexpected. Further research is needed to explore this finding.

Read the full article here.

Da Vinci’s hand impairment caused by nerve damage, not stroke

Da Vinci’s hand impairment caused by nerve damage, not stroke

First published on ScienceDaily.com

New analysis of 16th-century drawing by Italian doctors concludes da Vinci’s right hand affected by ulnar palsy, rather than stroke

A fainting episode causing traumatic nerve damage affecting his right hand could be why Leonardo da Vinci’s painting skills were hampered in his late career. While the impairment affected his ability to hold palettes and brushes to paint with his right hand, he was able to continue teaching and drawing with his left hand. According to most authors, the origin of da Vinci’s right hand palsy was related to a stroke.

Doctors writing in the Journal of the Royal Society of Medicine reached a different conclusion after analysing a 16th-century drawing of an elderly da Vinci, together with a biography and an engraving of the Renaissance polymath artist and inventor in earlier years.

The authors, Dr Davide Lazzeri, a specialist in plastic reconstructive and aesthetic surgery at the Villa Salaria Clinic in Rome, and Dr Carlo Rossi, a specialist in neurology at the Hospital of Pontedera, focused on a portrait of da Vinci drawn with red chalk attributed to 16th-century Lombard artist Giovan Ambrogio Figino. The drawing is a rare rendering of da Vinci’s right arm in folds of clothing as if it was a bandage, with his right hand suspended in a stiff, contracted position.

Dr Lazzeri said: Rather than depicting the typical clenched hand seen in post-stroke muscular spasticity, the picture suggests an alternative diagnosis such as ulnar palsy, commonly known as claw hand.”

He suggests that a syncope, or faint, is more likely to have taken place than a stroke, during which da Vinci might have sustained acute trauma of his right upper limb, developing ulnar palsy. The ulnar nerve runs from the shoulder to little finger and manages almost all the intrinsic hand muscles that allow fine motor movements.

Please read the full article here.