A spinal cord injury is defined as damage to a part of the spinal cord or the nerves at the tail end of the spinal canal (cauda equine). It often causes permanent changes in sensation, strength, and other body functions right below the site of injury. If you or someone you know has recently had a spinal cord injury, it may seem like all aspects of your life, and your family’s life have been affected. The effects of your injury will surely impact you mentally, socially, and emotionally.
Mechanics Of Stroke
As per the National Stroke Association, stroke is the number 5 leading cause of death among the majority of adults in America. It is also one of the leading causes of disability. However, since people are not aware of the common symptoms of stroke, treatment is usually delayed.
Our heart beats approximately 100,000 times daily, and each beat is in conjunction with blood that is pumped out from the heart. This nutrient and oxygen-filled blood goes through a system of vessels to all the cells in our body. That is the normal mechanism. When something goes wrong, like a blockage in a vessel, it stops the normal blood circulation to that particular area, and when this occurs to the heart, it is referred to as a heart attack. When this occurs to the brain, on the other hand, it is referred to as a brain attack or stroke.
Recognizing The Signs Of Stroke
There are definitive symptoms of stroke that you should watch out for. If you think you may be experiencing one, these symptoms occur suddenly and may include:
It is essential to be aware that stroke symptoms are not typically associated with any pain, which is why you may ignore them. It might be too late to realize that you are facing a critical condition that needs immediate medical attention.
Types Of Stroke
Understanding The Signs And Types of Stroke
When To Visit Your Physician
Whatever type of stroke you or someone you know is experiencing, you need to seek immediate medical attention. As per the American Stroke Association, approximately 2 million brain cells die from lack of nutrients and oxygen when the brain is deprived of blood for one minute. This damages the different functions of the brain, including those that are vital to everyday life, such as walking and speaking.
If you are at high risk for having a stroke, it is to your advantage if you are able to recognize its symptoms, the type of stroke you may have, and what steps you can take to make things easier for you. It might be cliché, but yes, truly it is better to be safe than sorry.
Glaucoma is a severe disease of the eye in which the fluid pressure rises. If left without proper medical attention, it may result in vision loss or worst blindness. That’s due to the permanent damage to the optic nerve. This type of eye disease is very common, especially among older adults.
The most common symptom of this eye disease is severe eye pain, and possible treatment may include surgery or non-surgery operation. However, over the years, research finds a lot of possible medications to treat glaucoma. The integration of technology into the medical field helps a lot in speeding up the process of medical assistance and its development. Below are some latest innovations in the glaucoma medication field.
Rhopressa or AR-13324
Glaucoma in the form of elevated IOP or intraocular pressure is mainly a disease of the outflow system through the trabecular meshwork or the outlet of the inner eye fluid. Past medication aims to enhance the trabecular flow; however, this technique results in some local ocular side effect. That is why today scientists are developing a drug that can reduce the pressure of the eye by enhancing uveoscleral or eye fluid outflow. Hence, there’s the creation of Rhopressa. Though FDA does not yet approve the new drug, its application is already pending for submission.
Aerie Pharmaceuticals developed the drug. It seeks an indication of “once a day” use of the drug to minimize internal eye pressure. However, according to the pharmaceutical company, the drug may work well only if it is combined with the use of prostaglandin analog (a type of hypotensive medication that treats glaucoma). The Rhopressa is still under development, but if it does prove that it can reduce episcleral venous pressure or internal eye pressure, it will open the gateway towards new therapeutic possibilities.
Trabodenoson
Aside from AR-13324 or Rhopressa, there is a second TM-targeted drug which works through a different molecular mechanism than Rhopressa. It is known asTrabodenoson. The new drug affects the inner eye outflow which is the actual source of the disease. It takes the treatment back to a therapeutic target and tends to point towards a different patient population. Patients with more elevated eye pressure are advised to take the drug.
The Trabodenoson is an adenosine A1 receptor agonist used to create a biological response to glaucoma. It helps in boosting up the outflow through regulating the trabecular meshwork cell production of matrix metalloproteinases (the enzymes responsible for normal tissue turnovers). Trabodenoson targets to drain better and reverse the tissue area of the eye for it to alleviate the pressure.
MicroPulse P3 Cyclophotocoagulation
It is a new type of MIGS or minimally invasive glaucoma surgery. Traditionally, techniques of common glaucoma surgeries burn the ciliary body, but with MicroPulse P3’s slow application of laser energy, it slowly slices into the cell tissue. Though the pulse, created by the laser, heats up, it does not burn the eye tissue. It is due to an integrating pause between each pulse.
MicroPulse helps the eye tissue to have time to cool off and not burn in the process. This procedure allows the eye tissue to change without a single damage. However, this method remains under development and requires FDA approval. Since no superior data support its validity as a proper treatment for glaucoma, it remains under observation and out of public reach.
Glaucoma is most often referred to as a silent thief of sight. The risk of having the condition may increase if the patient experiences thyroid problems. It can get worse with aging as well. But with proper medical treatment and well-assessed procedures, there’s a sure way of getting rid of it.
Glaucoma is a condition of the eye that damages the optic nerve. It can result in vision loss or much worst, blindness. Its pressure is a front-runner as a risk factor for this possible optic nerve damage.
What’s In The Eye?
The anterior chamber is the face in front of the eyes, and in it is a fluid that flows unceasingly in and out of it. The fluid provides nourishment to nearby tissues. It exits the chamber at an open angle located in the space where the cornea and iris converges and flows out like a drain through a spongy meshwork like structure.
In the case of open-angle glaucoma, the fluid inside the chamber is not adequately drained. Therefore, not all of the liquid makes out from the spongy meshwork. So when the fluid builds up in the chamber, it creates pressure inside the eye that possibly results in optic damage.
MIGS or minimally invasive glaucoma surgery is the latest glaucoma treatment available to the public. Apparently, in the United States, there are only two MIGS devices approved for the market and already in serious development. However, as soon as the application of the latest devices passes the proper testing and inspection, there are more devices ready for use.
Allergan – Allergan is a 6 mm XEN gel stent designed to lower eye pressure. It can be implanted through the trabeculum into the subconjunctival space of the eye through a little incision in the cornea. It is used mainly for patients with refractory glaucoma. The stent focuses on addressing refractory POAG in patients who suffer from unresponsive to maximum tolerated medical therapy. Up to date, there are more than 11,000 XEN gel stents placed all over the world.
CyPass Micro-stent – MIGS has already two approved devices in the market. There’s the Cypass, and the other one is the Glaukos or iStent. These devices reduce intraocular pressure or IOP for patients with mild to moderate POAG or open-angle glaucoma. According to experts, these devices can be easily implemented into practice by the most comprehensive ophthalmologists in the country. The invention is said to have a superior intraocular pressure lowering efficacy compared to a cataract surgery procedure.
Glaukos or iStent – It is one of the MIGS devices that are FDA approved, alongside CyPass. The iStent inject an injector has two preloaded stents. With the use of the injector, the two devices are implanted into the Schlemm’s canal to increase fluid outflow. Apart from iStent, the iStent supra also drains into the suprachoroidal space and iDose that serves as travoprost depot. It gets injected towards the sclera.
Equinox – Most glaucoma-related devices treatment methods treat glaucoma as a disease of elevated intraocular pressure; however, Equinox is different. The equinox approach to glaucoma focuses on looking at it as a disease of two pressures – by intracranial and by intraocular pressure. It labels the pressure gradient between ICP and IOP. It gently peels and eliminates eye dryness so it can replenish its nourishing extract.
InnFocus – One of the first minimally invasive devices for mild to moderate and severe POAG is the Microshunt. The device promises a sustained IOP that is below 15 mmHG. It somehow eradicates eye drop medication. As per record, it is the only device in a random controlled trial versus trabeculectomy.
There are many more risk factors that may relate to optic nerve damage and can lead to glaucoma. However, with early detection and treatment, there’s a minimized risk of having vision loss and glaucoma. There are some significant strides in the research towards treating glaucoma. Some of these innovative devices may change the way glaucoma is treated.
SCI or Spinal cord injury is a very costly injury. It often leads to psychological and social problems where intensive treatment and care becomes a necessity. Over the years, a variety of pharmacological agents are tested to aid the condition. A lot of these tests flunk, while a few others somehow manage to make small strides towards alleviating the results.
Although there’s an acquired positive laboratory result from large-scale controlled clinical trials, researchers fail to replicate the effect in human testing. Presumably, there are no signs of neurological benefits obtained from the investigative study for SCI treatment. However, some researches on surgical timing show that medical interventions, such as cellular therapy and transplantation, are safe and possible. That’s because the procedures improve neurological state and profoundly reduce overall health care cost.
The Current Evidence Of Surgical Decompression Role In SCI
The CNS or central nervous system healing capability is very limited. That is why most injuries experienced by the brain or spinal cord result into permanent overall dysfunction. However, researchers have found a way to ease the consequences of SCI, and this is through surgical decompression. It is where the spine surgery procedure plays a vital role in the treatment. According to research, undergoing an early surgery after the incident somehow ensures a positive effect for the patient who’s suffering from SCI. This information is supported by data from an early surgical intervention that has resulted in better long-term solutions.
A physical accident or a traumatic occurrence, mostly near-death experience, may result in sustained damage to the spinal column and spinal cord. Some of these incidents could be falling from a building, car accident, sports-related injury, and a lot more. These will result in unimaginable back pains or permanent malfunctions in the human body. But what’s stressful is the destabilization of the spinal column that changes the body’s anatomical structure, giving it a more complicated figure, unpleasant appearance, and useless function. So to resolve these issues, spine surgery is one of the options.
Decompression Procedures
There are different types of decompression procedures. There are laminotomy and laminectomy. These are two types of spine surgery that involves the spine lamina (the structural protective shielding at the back of the spinal canal). Laminectomy is defined as the actual removal or the complete removal of the lamina while laminotomy is only the partial removal of the lamina. The surgeon may choose between these two procedures to gain access to the nerve that is causing the SCI-related symptoms or pain.
There are some cases that spinal decompression is the best option for SCI. However, there are cases that the procedure itself can cause the spine’s instability. From that instance, the process becomes complicated. Since the spinal stabilization surgery, along with spinal fusion, is performed after the decompression procedure, the tricky part of the operation is due to the removal of soft supporting tissues (a disc or a bone). But even if there’s a possibility of complication, the surgeon still ensures a beneficial result from the decompression.
Instrumentation And Fusion
These are often included in the spinal stabilization procedure as well. Fusion involves autograft or allograft methods that are packed into and around the instrumentation of the spine’s structural healing and ingrowths. Instrumentation refers to the variety of implantable devices used to support fusion. These may include inter-body cages, rods, screws, and plates. Instrumentation provides an immediate spinal stabilization with the help of tools while fusion holds everything together like glue.
Decompression is one of the surgeries that may help a person continue a reasonable quality of life after a spinal cord injury. So it’s better to note that the longer a person waits before having surgery, the higher the risk of having permanent damage to the spine.
Brain infarction in stroke patients happens when the blood flow to an area of the brain gets blocked or cut off. During this incident, a part of the brain is deprived of oxygen and glucose (acute stage). As this progresses, the onset may present with cognitive impairment, mental health problems, difficulty with regular activity, motor impairment, and other health conditions.
This is why patients suffering from stroke need to go through modern stroke rehabilitation and therapy to help improve cognitive functioning, help with motor training in the lower and upper limb function through physical therapy, and overall functional recovery, especially for those with chronic stroke. Thus, we will discuss the latest type of recovery and therapeutic interventions.
If you want to know how patients can undergo rehabilitation and better regain motor recovery after an episode, reading this article on current techniques for therapy will help you learn more.
There are a lot of symptoms of stroke, and the most common are weakness and numbness of the affected arm or leg and dimming or loss of vision in one or both eyes. People may also experience severe headaches as a result of central nervous system involvement.
A stroke is a medical crisis, and it is essential to call for immediate medical treatment and rehabilitation post-incident to avoid any long-term permanent brain damage or any other injury such as loss of vision or paralysis. Therapy training is crucial regardless of the type – whether it be an ischemic, acute, or chronic stroke. Stroke survivors will tremendously benefit from several stroke recovery methods, such as neurological therapy, motor training, gait therapy, physical therapy, neuromuscular electrical stimulation, progressive resistance training, and electrical stimulation, among others, most of which are included in a more improved therapy.
There are many types of stroke, one of which is the cerebral type, which can also be an ischemic stroke. During cerebral hemorrhage, the ruptured veins flood the brain with a lot of blood that automatically creates pressure. In the robotic stereotactic method, there’s a creation of a three-dimensional map of the patient’s brain which allows the robotic surgical system to pinpoint at the highest accuracy. This helps in motor recovery, which is not part of conventional therapy.
Current therapy utilizes noninvasive brain stimulation techniques to improve the motor cortex and recovery in acute ischemic stroke patients. Transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and transcutaneous electrical nerve stimulation (TENS) are some of the noninvasive brain stimulation techniques used in therapy. Functional magnetic resonance imaging (fMRI) is also used to understand brain plasticity in patients and assess the effectiveness of noninvasive brain stimulation techniques.
In the acute phase, growth factor treatment has also shown promise in improving motor function and recovery. A controlled trial involving acute ischemic stroke patients showed that growth factor treatment combined with standard rehabilitation improved motor function compared to therapy alone. Overall, these new techniques employ a multidisciplinary approach utilizing noninvasive brain stimulation techniques, growth factor treatment, and other interventions to enhance recovery and improve motor function in patients. Stroke remains a leading cause of disability worldwide, and research in this area is ongoing to improve outcomes and quality of life for patients with stroke.
Stem cells are considered smart cells in the human body. They can multiply and reintroduce themselves into specific cells. Based on leading medical research, stem cell treatment for stroke patients begins with a safety efficacy evaluation performed by medical experts (this may have undergone randomized controlled trials). The attending medical practitioner determines whether the patient is qualified to know the severity of their condition.
The current therapy focuses on improving motor function and enhancing the quality of life for chronic patients. Constraint-induced movement therapy, transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS), and repetitive transcranial magnetic stimulation (rTMS) are some of the techniques used to improve motor function in patients. A randomized controlled trial demonstrated that tDCS combined with constraint-induced movement therapy had a significant impact on improving motor function in chronic stroke patients. Similarly, rTMS and electromechanical-assisted gait training (EAGT) have been shown to improve gait training in the chronic phase of stroke. Mirror therapy is another technique used in physical therapy to improve motor function.
Ischemic stroke occurs when there is a blood clot obstructing a blood vessel. The new treatment for this is through the administration of a tPA or tissue plasminogen activator. That is why The Scripps Research Institute developed the 3K3A-APC. Though this type of drug is still in the preliminary stage, it possesses an excellent potential for opening a new way to manage stroke, decrease motor impairment, and improve function.
The severity of stroke can vary for patients and survivors. If there’s no early detection, brain damage can occur, which will require restoration for this type of stroke. In some worst cases, it can lead to death. It is most common among the elderly, but there are cases where the younger age bracket is affected by the condition. It is important that we all observe a healthy lifestyle to lessen the risk of having it.
Current interventions involve an intensive training approach combined with a variety of interventions such as growth factors, induced movement therapy CIMT, brain stimulation techniques like transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), and assessment using magnetic resonance imaging (MRI). A systematic review published in the Arch Phys Med Rehabilitation found that these interventions, particularly growth factors, and CIMT, can improve muscle power and motor function in stroke patients.
Stroke patients, particularly hemiplegic patients, have impaired motor functions, making recovery after stroke even more important. Their affected limb is weak or paralyzed, requiring aggressive inpatient therapy and eventually outpatient therapy to facilitate rehabilitation after stroke. This would include functional electrical stimulation, gait therapy, neurological rehabilitation, walking practice, bilateral arm training for improving lower and upper limb function, and mental practice to alleviate cognitive impairment, among many others.
A spinal cord injury or SCI is the damage to any part of the spinal cord at the end of the cauda equine or spinal canal. Symptoms of SCI may include loss of muscle sensitivity and functionality. It triggers some automatic function below the site of injury, and it can happen in any part or level of the spinal cord. One of the worst cases of SCI is the total loss of muscle function and sensation. Thus, it is important to note the steps in handling SCI in its early stage or after the incident.
The Important Things To Know
Stabilization – After an individual suffers a traumatic event or accident, the very first priority of the rescuer is to stabilize the person’s breathing, spinal column, and blood pressure. It is necessary to not put any tension to the patient’s back to avoid troubled breathing. Most of the time, the recommendation of a cervical collar and backboard usage is a must as well. It is also essential not to place any unnecessary strain on the patient’s body that will cause further injuries. A patient suspected with SCI should be brought to a level 1 trauma center where they provide the highest form of surgical treatment and care to trauma inflicted patients. From there, the center offers a full range of surgeons, specialists and a variety of equipment to handle an SCI treatment procedure.
Injury Classification – With the use of modern medical tools such as X-rays, MRIs, and CT scans, doctors can entirely determine the extent of damage to the injury. With these methods, physicians can also classify or rule out SCI. Part of this procedure includes the patient going into a series of neurological examinations. During these series of tests, the doctor will then measure the amount of muscle tone, sensation, and reflexes of all the patient’s limbs and trunks. The results will be later referred to the ASIA (American Spinal Injury Association classification) for the spinal cord injury scale and then it is labeled according to its corresponding category.
Neuroprotection – Therapies such as neuroprotection aims to stop or minimize the body’s reaction to the injury from any spinal cord damage. During the first few hours of the injury, the use of methylprednisolone (a kind of steroid drug) is essential to the patient. It helps in minimizing the inflammation of the affected part so the patient can reach an improved recovery. Although no superior evidence supports this type of procedure, there’s still a high chance of better results from it. Another form of neuroprotection is therapeutic hypothermia or mostly known as spinal cord cooling. This treatment lowers the overall body temperature to protect the cells in the body from further damage after SCI.
Surgical Intervention – There’s a need for early surgical intervention on patients with SCI. The early detection and treatment for SCI cases aim to remove the risk of permanent damage. The process seeks to stabilize the patient’s condition by discussing possible surgical intervention or procedure. There’s also a proper treatment plan that can estimate the recovery time. The recommendation of a surgical procedure is due to several reasons such as removal of bone fragments, blood clots, herniated disks, spinal tumors, and anything else that may affect the function of the spine.
The symptoms of the injury vary depending on its location. Spinal cord injury most of the time causes enduring changes in body strength, sensation, and other body functions. That is why it is vital to act immediately after the occurrence of SCI because there’s a possibility of having permanent damage. Therefore, the earlier the treatment procedure is administered to the patient, the more significant the chance of recovery.