09 December 2005

What Happens During Stroke?

During cases of stroke, there is a popular saying that "time is brain," meaning that the longer treatment is delayed, the poorer the prognosis or clinical outcome for the patient involved.

In a recent article by Dr Jeffrey L Saver, of the Department of Neurology of UCLA, in the journal Stroke, here are some of the quantifications he found using a systematic literature review:

  • Every HOUR, patients experiencing a typical large vessel acute ischemic stroke undergo a loss of 120 million neurons, 830 billion synapses, and 714 kms or 447 miles of myelinated fibers.

  • Every MINUTE, 1.9 million neurons, 14 billion synapses, and 12 kms (7.5 miles) of myelinated fibers are destroyed.

  • Compared with the normal rate of neuron loss in brain aging, the ischemic brain without treatment ages 3.6 years each HOUR.

The average human brain has about 100 billion neurons and 100 trillion synapses between them. This recent article by Dr Jeffrey Saver helps us appreciate how fast everyone --- relatives of the patient, paramedics, doctors, and nurses --- should move in initiating medical treatment to the affected patient.

Indeed, time lost means brain tissue lost.

Lost brain tissue means neurologic deficits --- paralysis, slurring of speech, disorientation, etc. These are things no one wants to happen to himself or to a loved one. So, when you suspect a stroke, be sure to move fast, and get that person to the nearest hospital.

8 reactions:

may said...

this is late but better than never. congratulations are in order. congratulations! celebration is expected. how about steaming hot puto bumbong? yum...you know, straight from the crowded, full of life street of baclaran or something...not like the frozen imitations here, which you have to microwave, and just ruins the whole idea.

sorry, i'm homesick...but seriously, congratulations!

Anonymous said...

This analysis is very misleading. It's like comparing the wear and tear on roads from daily driving to what damage may occur to a road during an earthquake. It is simply not helpful and makes no sense to refer to equivalence in terms of brain aging. Brain wear and tear is diffuse. Stroke, generally, affects a specific part of the brain - often devastating it.

Dr. Emer said...

Thanks, May. I appreciate that. If only I can send you hot puto bumbong, I will. Hamo, treat kita when you go home. :)

I partially agree, Mr. Anonymous. Were you able to read Dr Saver's study abstract? While "daily-wear-and-tear" isn't comparable to an "earthquake," as what your comparative analogy implies, I think the study has met its objective....which is to quantify in real terms what "time is brain" means. You've said it yourself, stroke "affects a specific part of the brain - often devastating it." That "devastation" was quantified and I believe there is nothing misleading there. Also, I would appreciate it if you can identify yourself properly next time. Thanks.

... said...

...too true.
you write wonderfully well

Dr.Alway said...

I previously posted as anonymous. OK, I have no objection to attempting to quantify the rate of neuron loss/cell loss associated with an ongoing ischemic stroke. It might be quaint, but who knows, it may be useful information to know as well. The silly part of your post deals with attempting to translate that information into equivalent years of brain aging. Just because you CAN compare two types of numbers with eachother, doesn't mean you should or that anything useful comes of it. Mr. Johnson, you've just lost the same number of neurons as you normally would by aging for 10 years! Thanks doc, but save that information for your next cocktail party. Do you think I will walk, will I get feeling back in my leg?

Dr. Emer said...

Thanks for identifying yourself, Dr Alway. I would just like to correct your impression about the "silly part" in my post. My post merely reported what Dr Saver said in his paper. It will be published in the January 2006 issue of Stroke. As I've said in my previous comments, read the links provided in the post, and be enlightened. I respect your opinion if you think the analogy is "silly" and good for "cocktail parties" only. I can assure you, I have no intentions of misleading anyone. Nor do I believe that Dr Saver meant it as you described. Besides, that was not the point of my post nor Dr Saver's paper.

beajerry said...

Great post!
I do think it is helpful to put a more substanitive mental picture around brain function loss caused by stroke. It helps paint a clearer picture of the challenge a healthcare provider is up against, and that helps speed up their response.
But I would agree with Dr. Alway's comments only in reference to the comparison of stroke damage to normal brain aging. The stroke damage is specific in area (usually), and normal brain aging is general.

Anonymous said...

If you think that his comparison is silly Dr.Alway and that it is not useful, then why are you wasting your time being controversial about it.