2019.02.01 01:24
2019.02.01 01:31
2019.02.01 01:44
2019.02.01 01:46
2019.02.02 18:42
With this tragic disease with such a narrow window of time for physicians and patients in the past,
recent progress in interventional neuroradiology is reassuring news,
that we could do something that can improve pt's outcome substantially.
It appears that teamwork in the hospital is the key element in emergent neuro intervention
and component of "luck" still matters, whether or not pt's dominant hemisphere(Rt vs Lt) got injured.
2019.02.03 02:21
One thing that comes up to my mind.....
No matter how wonderful the interventional medical technology may be,
if one gets a stroke at 1:00 AM in the morning, it doesn't do any good to him.
One has to be very lucky and "timely" to get the benefit of such progress.
Have you seen a radiologist waking up and coming to E.R. at 1:00 AM?
I have not seen such a thing.
I do know that a thoracic surgeon hurries up to E.R. at any time of the day
but not a super-specialist radiologist. I am sure you know that too.
As you mentioned in another webpage, you have to get a heart attack near the hospital to get to be alive.
If one gets it on an airplane, it's too bad. He may be out of luck.
2019.02.03 02:53
You are right, WM.
"That's the way it is." Walter Cronkite would say.
However, medicine is much better organized nowadays,
not like the days we practiced.
These comprehensive stroke centers have 24 hours a day on call schedule
which has doctors and nurses on call at night.
Theses doctors and nurses do come in 1:00 AM within 30 to 60 minutes
coinciding with the arrival of the patient at the procedure room where the
endovascular therapy is performed.
This is how cardiologists dealt with acute MIs for years, and
the stroke centers adopted the same approach to deal with the acute strokes.
I was there for a number of years organizing and carrying out the system
for acute MI management so that you can be reassured the neuroradiologist
on call will show up on time if you arrive at 1:00 AM at a recognized CSC.
Basically we now treat the acute major stroke the same way
we've been treating acute MIs for years, which seems to make sense.
From the patient's perspective finding a well-recognized reputable comprehensive stroke center(CSC)
that provides endovascular therapy 24 hrs a day fast enough would be a critical matter.