The vast majority of strokes in the U.S. are caused by a blocked artery, but about 13% of strokes are caused by a brain hemorrhage—and these are particularly deadly. Up to 50% of people with hemorrhagic strokes die within 30 days. Globally, about 30% of strokes are hemorrhagic, and about 60% of such strokes are caused by high blood pressure.
Source: Stroke Awareness Foundation
Source: Stroke Awareness Foundation
According to the Georgia Department of Health, Georgia is located in the “stroke belt,” an area in the southeastern United States where the stroke death rate is about 30% higher than the rest of the country. Georgia’s coastal plains are in the “rounding off” of the Stroke Belt, an area where the stroke death rate is about 40% higher than the rest of the country.
The Emory doctor who led the study known as REACH said the new, minimally invasive technique, refined through ongoing research funded by the Marcus Foundation, has the potential to shorten intensive care unit stays for stroke patients at Grady Hospital, where stays can sometimes last more than two weeks.
“This initiative represents a significant step forward in the advancement of treatment for hemorrhagic stroke,” said Dr. Gustavo Pradilla, a neurosurgeon who led the research at Emory University.
In addition to Pradilla, the principal investigators for the REACH trial are Dr. Jonathan Ratcliff, assistant professor of emergency medicine at Emory University School of Medicine and director of the neurology critical care unit at Grady Health System, and Alex Hall, assistant professor of emergency medicine and director of clinical research at Emory University School of Medicine.
The REACH project aims to follow on from a previous study known as ENRICH.
The ENRICH study concluded earlier this year, and its results are noteworthy because they prove that a novel surgical technique for removing blood clots from hemorrhages is not only effective, but in some cases it also shortens recovery time to a few days, the AJC reported in April.
Pradilla told the AJC that the new technique represents a paradigm shift because it guides a small instrument through a small incision into the brain to reach and remove blood clots formed by a hemorrhage. Previously, the standard surgery to remove blood clots from the brain required a conventional craniotomy—a large incision in the skin, removal of part of the skull, and then a laborious process of reaching the blood clot itself. That process can involve suctioning out or cutting brain tissue, leaving open the possibility of additional brain damage from the surgery itself.
In this latest study, the team will take what they have learned from treating bleeds in areas of the brain closer to the skull and apply it to strokes that occur in a deeper area of the brain called the basal ganglia.
A hemorrhagic stroke occurs when a weakened vessel bursts and bleeds into the surrounding brain. The buildup of blood inside the skull can crush brain tissue and cause damage.
Like the ENRICH study, the REACH study will use two medical devices made by Nico Corporation, based in Indianapolis. One device, called the BrainPath, looks like a screw and essentially moves brain tissue to the side to avoid damage. The other device, known as the meniGLIDE, removes the hard pieces of blood, or clot, by suction.
The ENRICH study found that the procedure is most effective when done within 24 hours of a stroke. This is because the brain recognizes blood clots as foreign bodies—and in an attempt to remove them, it essentially attacks the clots, leading to inflammation that causes pressure in the skull and, in many cases, death. Before the ENRICH study, it was not clear whether the benefits to the patient outweighed the risks of surgery.
The REACH study will enroll about 600 patients at 60 stroke centers across the country over four years, with enrollment set to begin in December. It will also create a data repository that will inform future clinical practices, Emory said in a news release.
Since 2008, the Marcus Foundation has given more than $72 million to the Emory/Grady team for stroke research, prevention, and treatment.
“After witnessing the staggering death and disability that strokes cause, I knew we had to do more to discover new treatment options,” says Bernie Marcus, founder of The Marcus Foundation and co-founder of Home Depot. “Breakthroughs like this new approach to the deadliest form of stroke and others by the distinguished team at Marcus Stroke & Neuroscience Center will save and change lives around the world for decades to come. This is an extraordinary philanthropic return on investment.”
Facts about stroke
In the United States, approximately 795,000 people suffer a stroke each year and more than 140,000 people die from a stroke.
Stroke is also the leading cause of serious, long-term disability in the United States. There are more than 7 million stroke survivors in the United States, and two-thirds of them are currently disabled. About 25% of people who recover from a first stroke will have another within five years.
To prevent strokes, the Stroke Foundation recommends taking the following steps:
Work closely with your doctor to control conditions that increase risk, such as high blood pressure, high cholesterol, atrial fibrillation and diabetes.
If you smoke, quit. The risk of ischemic stroke is twice as high in smokers than in nonsmokers.
Drink alcohol in moderation. Regularly drinking large amounts of alcohol can cause increased blood pressure.
Eat a healthy diet. This includes reducing or eliminating saturated and trans fats, lowering sodium intake to about 2,000 mg per day, and eating more fruits and vegetables. Most processed foods and fast foods should be avoided.
Exercise regularly. Physical exercise has many beneficial effects on the heart and blood vessels, including strengthening the heart muscle, increasing oxygen absorption, lowering blood pressure and maintaining a low weight.
Lower stress levels. Although some stress is unavoidable, stress contributes to high blood pressure. By managing stress with exercise, relaxation techniques, and counseling, if necessary, the risk of stroke can be reduced.
Source: Stroke Awareness Foundation
#grant #Marcus #Foundation #Emory #University #School #Medicine #Gradys #Marcus #Stroke #Neuroscience #Center #research #treatment #hemorrhagic #stroke