Saturday News

Contents of This Week Saturday News:

• Headline - Medical Tricorder / XPrize

A Medical Tricorder is a handheld portable scanning device to be used by consumers to self-diagnose medical conditions within seconds and take basic vital measurements. While the idea for a Medical Tricorder has been mostly hypothetical until May 2013, there are reports that a firm named Scanadu has built one which they call the Scanadu Scout. While the device is not yet on the mass market, there are numerous reports of other scientists and inventors also working to create such a device as well as improve it. A definition from Wikipedia and video clips from YouTube / Vimeo.

• Eclectic - Many articles from many Guest Bloggers about Stroke
• Brain Food’s First Dish
• 50 Shades of Stroke – Kindness
• Physical Exercise Effects on Brain EEG
• My Husband is Not Disordered! Speech Therapy Aphasia
• Living too far Away from Stroke Centers
• Cerebellum
• Psychotherapy: It's Been My Life Changer
• When Stroke Recovery Doesn’t Happen.
• ‘Would you like a cheese sandwich?’ #strokerecovery
• Weekly Columnists
• Musing: Golden Hour' Care Unlikely for One-Third of Americans
• Sunday Stroke Survival: Science Fiction / Science Fact
• Caregiver: "Tooling Around"
• Jackie The Jester: The Centipede
• TED Talks - Joseph DeSimone: What if 3D Printing was 100x Faster?
• Rick Mercer Report: Parapan Am Games Training
• Laid-Back Administration: Tim Seefeldt & Thanks Google
• Daily Comics: FB Or FW, Dilbert, Mayes, Doonesbury

Definition: Medical Tricorder / XPrize

See additional definition of: 1) Tricorder (of course from Star Trek) and 2) the contest Qualcomm Tricorter XPrize  and 3) Pulse Oximetry (invented more than 20 years old in the hospital)...

Medical Tricorder From Wikipedia,
      the free encyclopedia

Smartphones may be used as medical tricorders; smartphone
software and camera detect pulse from a fingertip using a
technique similar to that of a pulse oximeters.

A medical tricorder is a handheld portable scanning device to be used by consumers to self-diagnose medical conditions within seconds and take basic vital measurements. While the idea for a medical tricorder has been mostly hypothetical until May 2013, there are reports that a firm named Scanadu has built one which they call the Scanadu Scout. While the device is not yet on the mass market, there are numerous reports of other scientists and inventors also working to create such a device as well as improve it. A common view is that it will be a general-purpose tool similar in functionality to a Swiss Army Knife to take health measurements such as blood pressure and temperature, and blood flow in a noninvasive way. It would diagnose a person's state of health after analyzing the data, either as a standalone device or as a connection to medical databases via an Internet connection. A Time Magazine reporter described the Scanadu Scout:

A hockey puck-shaped object that can apparently measure your temperature, heart rate, oximetry (blood oxygenation), run an electrocardiogram, gauge heart rate variability, clock pulse wave transit time (related to blood pressure), perform a urine analysis and calculate a metric Scanadu refers to (vaguely) as "stress." All you have to do to get these readings, urine analysis notwithstanding, is hold the Scout against your forehead for a few seconds. 

—Matt Peckham in Time Tech, May 2013

Video: Medical Tricorder / XPrize

Healthcare in the Palm of Your Hand
               Qualcomm Tricorder X PRIZE

Published on Oct 16, 2012

SSTattler: X-Prize announced October / 2010 and judging December / 2015...

http://qualcommtricorderxprize.org

Imagine a portable, wireless device in the palm of your hand that monitors and diagnoses your health conditions. That's the technology envisioned by this competition, and it will allow unprecedented access to personal health metrics. The end result: Radical innovation in healthcare that will give individuals far greater choices in when, where, and how they receive care.

http://xprize.org


Standard YouTube License @ XPRIZE

Eclectic Stuff

Definition: Eclectic(noun) a person who derives ideas, style, or taste from a broad and diverse range of sources.

Brain Food’s First Dish

Tim Seefeldt
Brain Food Cafe for the Mind

March 15, 2015

I couldn’t have written this blog five years ago. That’s because a stroke sizzled the back left side of my brain erasing my ability to read and write.

It zapped lots of other important bits, too. I was only 45, married and the father of two teen-aged girls. There were no warning signs. I’d just had a physical and seemed the picture of health. But in the blink of an eye, it looked like I’d never be able to provide – emotionally of financially — for my family again.

And the salt in the wound was that I’d been a newspaper reporter with a dream to write books that I never got around to writing. Use it or lose it, it seemed.

But it turns out that you can put Humpty Dumpty back together again. Through a blend of science, art, faith and hope I literally relearn my ABCs, how to make change and loads of other simple stuff that I used to take for granted. Thanks to this and some technology, I’m tapping out stuff on the keyboard again.

Today – March 15 – is my five year strokeaversary. To mark it, I’m going to put my rekindled writing to work on regular posts on some of the Brain Food that helped me get my noggin firing again. I’ll also share stories of amazing brain feats and phenomenon and pass on loads of things everybody can do to keep firing on all cylinders. Or maybe even to crank up the engine to become a brain Ferrari.

50 Shades of Stroke – Kindness

Sas Freeman

March 22, 2015

It is a week now, since the Stroke Association Resolution Run held at the beautiful Hagley Hall in Worcestershire. The generosity began with Lord Cobham’s kindness allowing us to host the event at such a stunning venue.

Hagley Hall

I was invited to give a small speech before the race, the warmth and kindness given in return by the people present was incredibly moving to me. But what they didn’t realise was that THEY who are special people who made the day and other days like it possible and special. For whatever reason took them there: running, cheering or supporting it was hugely appreciated and each and every one of you are respected for what they did, and I address YOU all now and give a huge thank you.

A crisp cold morning, didn’t deter these kind dedicated runners and supporters, who were ALL amazing. This being Mothering Sunday too, lots of families attended before heading off to their well-deserved Sunday lunch. I met some truly wonderful people and left the venue, that lunchtime, on a total high. Reflecting on it, a hundred and eighty plus people, most of which I had not met before, all so cheerful and engaging in wonderful conversation. It’s amazing that such an event can make strangers feel so close.

Physical Exercise Effects on Brain EEG

Bill Yates
Brain Posts

Mar 17 / 2015

There are a variety of methods to study the effects on exercise on brain function.

Brain imaging techniques such as fMRI provides a new tool to search for regional effects of acute and chronic exercise.

Another tool that has received less attention is the electroencephalogram or EEG. One EEG measure of brain function is the individual alpha peak frequency or iAPF.

The iAPF is positively correlated with arousal, attention and speed of information processing. Higher iAPF is linked to faster speed of information processing.

Boris Gutmann and colleagues from the German Sport University Cologne recently published a study of the effects on acute and chronic exercise on iAPF.

My Husband is Not Disordered! Speech Therapy Aphasia

Mark A. Ittleman
The Teaching of Talking

Published on Mar 25, 2015

In this video Moshe Mark discusses how words conjure up negative thoughts and images about speech problems and aphasia.

http://www.teachingoftalkingcom http://www.teachingoftalkingtraining.com
http://www.facebook.com/teachingoftalking
http://www.facebook.com/moshemarkittleman


Standard YouTube License @ Mark Ittleman

See the original article:

My Husband is Not Disordered! Speech Therapy Aphasia

in

The Teaching of Talking

Living too far Away from Stroke Centers

Jeff Porter
Stroke of Faith

Thursday, March 19, 2015

Too far, too long.

Rural America is especially hard hit when it comes to stroke centers "over an hour away" for one third of Americans:

▶ "Even under optimal conditions, many people may not have rapid access to comprehensive stroke centers, and without oversight and population level planning, actual systems of care are likely to be substantially worse than these optimized models," says Dr. Mullen.

▶ Levels of access to care also varied in different geographical areas. Worryingly, access to care was lowest in an area often referred to as the "Stroke Belt" - 11 states where stroke death rates are more than 10% higher than the national average, predominantly situated in the southeast of the US.

▶ "Reduced access to specialized stroke care in these areas has the potential to worsen these disparities," says Dr. Mullen. "This emphasizes the need for oversight of developing systems of care."

So the people who are most likely to need the care are also the most likely to be too far from care. We can - and must - do better.

See the original article:

Living too far Away from Stroke Centers

in

Stroke of Faith

Cerebellum

Amy Shissler
My Cerebellar Stroke Recovery

March 16, 2015

My therapist told me today that NPR is doing a fascinating series of shows this week about the cerebellum.  It obviously caught my attention.  Here it is.  I kinda always thought that the cerebellum only affected physical stuff, boy was I wrong.  Physically, the cerebellum ‘fine tunes’ movements.  Like the writing thing that I cannot do, my brain can’t control that fine motor movement enough to let me do that.  Bringing a fork or drink to my mouth with my right hand, can’t do it.  I don’t have the fine tuning of that movement anymore.

So since the cerebellum controls fine motor movements, it makes perfect sense that the cerebellum would also have a role in fine tuning emotions.  This I also lost.  Sometimes, I just can’t control my emotions or the way that I act.  I can’t put on the brakes to my emotions that I used to be able to do and that is socially acceptable.  I can fly off the handle at a moment’s notice, if the wrong thing is said to me.  And I hate it.  I would voluntarily amputate my “good” left arm if it meant that I never had to deal with these emotions anymore.  Unfortunately, until Pat came into my life, nobody except one friend of mine tried to understand this about me and very often things were said to me to make my anger much worse.  This has led me to cutting off communication with certain people because I just can’t keep banging my head against the wall trying to explain this and getting nowhere.  Talk about stress.  Meditation helps this greatly.  C’mon neurologists, seriously.  There is so much that neurologists should be recommending to patients that have loads and loads of research, Dean will tell you all about it.  But my big thing is meditation.  So, c’mon docs, you’re being negligent.

Meditation research articles

See the original article:

Cerebellum

in

My Cerebellar Stroke Recovery

Psychotherapy: It's Been My Life Changer

Joyce Hoffman
The Tales of a Stroke Patient

Feb 14, 2015

When one thinks about therapy for stroke survivors, physical, occupational (which is a dumb name to begin with--it doesn't have anything to do with a job), and speech therapies are the obvious choices. All the rehabs provide the same, old thing. But what's the missing piece? Psychotherapy, of course! None offer that as routine.

My partner suggested mental therapy almost six years ago. But I didn't do it, not because I didn't think that I needed it after the stroke that caused maximum heartache to both of us and almost ultimate death to one of us; I didn't do it because I wasn't ready. That's the way it was then, and nobody, not even my partner, could change it.

Even if you think you're perfectly all right (which actually no one is) and especially if you think you're not, everyone should experience mental therapy sessions at least once in a lifetime. Most, if not all, insurance plans cover it. You can choose a licensed social worker, a psychologist, a psychiatrist, the latter being able to write prescriptions. But all of them give support with something, maybe a chain of somethings, you just can't figure out.

When Stroke Recovery Doesn’t Happen.

Kate Allatt
Stroke Recovery Tips

March 15, 2015

I’ve long been associated with the notion that stroke recovery is always possible, whether those improvements are small or large positive changes.

However, I have to admit that since meeting Kati Van De Hoeven in beautiful Finland last weekend, I’ve met someone who sadly hasn’t made very much physical improvement in twenty years, after her brainstem stroke and locked in syndrome diagnosis. Whilst she eats, writes books and blogs, plans meals, enjoys retail therapy – if it involves boots and bags – moves her head and eyes very effectively, but she is unable to do much else.

Kati is now forty years old and yes, she suffered her illness at the shockingly young age of nineteen and a half, in her prime and as a successful model living in LA. It would be fair to say that she looked like a brunette version of Cindy Crawford!

Her phenomenal blog can be read here. Kati has been my second heroine (my first being Ms Christine Waddell) since I came across her blog on Facebook early last year.  Her unique approach to life inspires me and quite frankly stops me immediately if I ever start to go down a self-pitying track about everything I’ve personally lost since 18.09 on 7th February 2010.  You really are either a glass half full or half empty kind of person and I’m definitely, and mostly, the former!

‘Would you like a cheese sandwich?’ #strokerecovery

Kate Allatt
Stroke Recovery Tips

March 21, 2015

Now be honest, are you so busy with juggling the balls of your own life – work, kids, partner, home, family etc – to be able or willing to care about for the needy and vulnerable people on our society?

Truthfully, this was perhaps a bit more like me pre-2010 – although I did a few charitable fundraising challenges and donated my skills to a local charity, before my own D-Day!

It may be the case that you care but struggle cope with others vulnerabilities, fragilities or mental health issues, so you steer a course away from the ‘said’ damaged individual?

Perhaps, you are selfish narcissist and are solely focussed in pursuing your own personal fortune and agenda? Sadly, there are quite a lot of people like that in the world.

Maybe, a your friend or relative who actually kindly visits you, but then is only able to offer patronising ‘sympathy’ or asks, ‘would you like a cheese sandwich?’

Weekly Columnists

Musing: Stroke Rounds: 'Golden Hour' Care Unlikely for One-Third of Americans

Dean Reinke
Deans’ Stroke Musing

Thursday, March 5, 2015

And because the stroke medical world has put all their eggs in the tPA basket strokies are f*cking screwed. tPA gets to maybe 10% of the people that are eligible for it at stroke centers and of those that get it it fully works to reverse the stroke only 12% of the time.  That scenario is one of the many reasons why the complete stroke medical world needs to be destroyed. This is why we need fast, objective diagnosis of strokes that don't require neurologists or scans or a stroke center for most patients.
Like this:

1. New EEG electrode set for fast and easy measurement of brain function abnormalities
2. Eye-Tracking Tool Might Quickly Spot Stroke
3. How the wave of a wand can detect bleeding in the brain
4. Neurokeeper EEG Headset Spots Signs of Stroke in Brainwave Signatures
5. Pupil response via infrared light
6. Brain oximeter and frontal near-infrared spectroscopy
7. Ischiban headband

Maybe you want to look at these:

• The Qualcomm Xprize for the tricorder has selected 10 finalists?
• I've already pointed out these 17 ways for objective diagnosis.

Stroke Rounds: 'Golden Hour' Care Unlikely for One-Third of Americans - Even under an optimistic scenario, as many as 114 million people in the U.S. would be unable to reach a comprehensive stroke center (CSC) using ground transportation within the critical treatment "golden hour," researchers estimated.

Sunday Stroke Survival: Science Fiction / Science Fact

Jo Murphey
The Murphey Saga

Sunday, March 22, 2015

It seems every day a new science fiction gadget appears in real life. What I'd really like to see is the medical tricorder appear from Star Trek. How cool what that be? A device to scan body systems, and diagnose your medical condition.

No waiting for hours on end for an MRI or x-ray, or blood tests before treatment begin. Just imagine what it would do for stroke patient where minutes equal the death of brain cells, death, and disability.

My neurologist and cardiologist have had a new toy for the past couple of years where you click off a bunch of symptoms and it searches a medical database for illnesses that match the symptoms which I thought was cool also. They were also gracious enough to let me play with theirs. The PDR (Physicians Drug Reference) has been an application for years for prescribing medications. So I was biding my time for someone to invent a working tricorder for medical use.

Caregiver: "Tooling Around"

Diane
The Pink House On The Corner

Friday, March 20, 2015

For the past four years, as most of you know, Bob has been pretty much bed bound. I mean, he really only gets up out of that hospital bed when I force him to because we have somewhere to go -- i.e. doctor's appts., therapy, medical tests or rare scheduled "fun" thing.  In the past, many well-meaning folks (other caregivers and medical providers) have advised me to contract with one of the "house call" medical groups, meaning doctors/nurses/therapists who come to the home instead of us going to them, but I've always refused, because, I tell you, if we did that, Bob would never move out of that bed at all.

And I do think getting up and going somewhere is good for his soul, even if only to a doctors office, even if it means more work for me.

So it was quite a shock, a real surprise, and a truly wonderful development that Bob, 2 weeks ago, wanted to, for the first time ever, get out of bed and, in his words,  just "tool around" on "the remote".

Um, "The Remote" is the name he uses for his new power chair....  all righty... Took me awhile to figure out what he was talking about there...

Anyhoo, two times, since the move, he has requested to get out of bed to just "tool around".  He has been excitedly exploring the house and the neighborhood (in the company of me and Boomer).  He is, also, learning to maneuver "the remote" -- though our woodwork, doors and walls pay the price!

I tell you, the move to this new house and the new power chair have been truly a Godsend for Bob. He certainly is coming out of his shell. And this interest in just "tooling around" would not have happened at our former (very small) house with the old manual wheelchair...

Here's some pics from our last adventure:

Jackie The Jester: The Centipede

Jackie Poff
Stroke Survivors Tattler

A single guy decided life would be more fun if he had a pet. So he went to the pet store and told the owner that he wanted to buy an unusual pet.

After some discussion, he finally bought a talking centipede, (100-legged bug), which came in a little white box to use for his house.

He took the box back home, found a good spot for the box, and decided he would start off by taking his new pet to church with him. So he asked the centipede in the box, "Would you like to go to church with me today? We will have a good time."

But there was no answer from his new pet. This bothered him a bit, but he waited a few minutes and then asked again, "How about going to church with me and receive blessings?"

But again, there was no answer from his new friend and pet. So he waited a few minutes more, thinking about the situation.

The guy decided to invite the centipede one last time. This time he put his face up against the centipede's house and shouted, "Hey, in there! Would you like to go to church with me and learn about God?"

This time, a little voice came out of the box, "I heard you the first time! I'm putting my shoes on!"

TED Talks - Joseph DeSimone: What if 3D Printing was 100x Faster?

Published on Mar 19, 2015

SSTattler: Hmmm, a 3D printing will help the invention of Tricorder device... maybe anyway... I’ll have to think a bit more...

What we think of as 3D printing, says Joseph DeSimone, is really just 2D printing over and over ... slowly. Onstage at TED2015, he unveils a bold new technique — inspired, yes, by Terminator 2 — that's 25 to 100 times faster, and creates smooth, strong parts. Could it finally help to fulfill the tremendous promise of 3D printing?


Standard YouTube License @ TED

Rick Mercer Report: Parapan Am Games Training

Published on Mar 18, 2015

SSTattler: Great device Anti-Gravity Treadmill in SSTattler January 25, 2014.

Rick trains with wheelchair racer Josh Cassidy and visually impaired long distance runner Jason Dunkerley at the Toronto Pan Am Sports Centre.


Standard YouTube License @ Rick Mercer Report

Laid-Back Administration: Welcome Tim Seefeldt !!

Dr. Beagle C. Cranium
Stroke Survivors Tattler

Welcome Tim Seefeldt to the Stroke Survivors Tattler

Tim had a stroke five years ago, he is lives in Edmonton,  he is a newspaper reporter, he started a blog, Brain Food Cafe for the Mind, and he is now a Guest Blogger for SSTattler. Here is Tim's biography in About Us and a copy below. Welcome Tim!

Dr. Beagle C. Cranium

Stroke Survivors Tattler

SSTattler Blogger - Tim Seefeldt

Tim Seefeldt
Brain Food Cafe for the Mind

• I am a newspaper reporter by trade, born and raised in Alberta, Canada.
• My old life ended early on the morning of Monday, March 15, 2010. I woke up that morning -- the first day after a long business road trip – tired and groggy, but otherwise fine.
• I figured a shower would shake off the cob-webs. But my right side wasn’t cooperating. I couldn’t make my right leg work like it was supposed to, and being half blind wasn’t helping either. Never mind the confusion. 
• My wife heard me bang and crash my way down-stairs. She looked scared. I remember her saying that she was going to call an ambulance. When I didn’t argue, she looked even more frightened.
• These were the first moments of my new life. I was only 45 and the sole bread earner for my wife Patricia and my daughters, Kristina and Anna, who were 16 and 13 at the time my brain decided to short circuit.
• I found out later that I’d had a large left posterior cerebral artery territory infarct. While that, like much else, made no sense to me.
• It was shocking, I was an ex-newspaper reporter with designs on writing a book one day. Now, in a flash, I couldn’t read or write.
• Five years later, I still have deficits like not being able to read at even close to normal speed. My brain just can’t recognize words the way it used to.
• But I’m able to work and live a meaningful life and function as an active father and husband. I learned to manage stress differently - giving myself more work-life balance - to keep my general health in check. Now, when I’m stressed, if I get a head ache or feel pushed, I slow down - take a walk, or whatever I can do to stay calm..
• Please look at my blog site - Brain Food Cafe for the Mind.

Laid-Back Administration: Thanks Google!

John C. Anderson
Stroke Survivors Tattler

I got an invoice from Google:

We're attaching a copy of your monthly invoice, detailing your Google Enterprise activity, for your records. There's no action required on your part as we'll continue to charge you automatically using the payment info we have on file.

Well, I was bit angry at least! My Google invoice yearly is $10.00 USD for the domain Stroke-Survivors.org and that is all! So, I opened my invoice they said:

Bill to:          Details:
---------------   ---------------------------  
JOHN C ANDERSON   Credit memo number:     ...
     ...          Issue date:             ...
     ...          Payment terms:          ...
     ...          Billing ID:             ...
                  Billing Account Number: ...

Google Enterprise
--------------------------------
Account ID: stroke-survivors.org 

Description           Amount ($)
--------------------------------
Courtesy                  -10.00 
Subtotal:                 -10.00 
* Tax (0%):                 0.00
Amount in USD:            -10.00

They gave -$10 bucks back for “Courtesy"! I was flabbergasted! Google Enterprise is a very, very large corporation. I know the billing address (in California) but to call them is difficulty at least and SSTattler only with 1 employee i.e. me (maybe 2 if you include Dr. Cranium). Maybe it is:

• the topic of Stroke it very important but I do not think so for Google,
• the great 43 blog/e-mail Guest Bloggers but I do not think so for Google,
• very nice readers / e-mail of SSTattler but I do not think so for Google,
• Wikipedia is completely free so anybody can do it,
• YouTube is mostly free and it is part of Google so I do not think so,
• lots of ideas but half baked, rolling around my partly broken brain,
• Hmmm, I really do not know what ticks in Google - I’ll have to visit Larry Page and Sergey Brin, have coffee, and they will tell me!

Well I can least say "Thanks to Google Enterprise" from a "Courtesy" invoice. Thank-you!

---
John C. Anderson
Stroke Survivors Tattler

Daily Comics

For Better and For Worse
Lynn Johnston

Canada Family Events

Dilbert
Scott Adams

Dilbert Office Events

Edmonton Journal
Malcolm Mayes

Politics Views from Canada

Doonesbury
Garry Trudeau

Politics Views from USA

  

** I tried to get low or free price at the people http://www.UniversalUclick.com/ for the images for the cartoons. It was too high for Stroke Survivors Tattler i.e. we are not a regular newspaper and our budget is very, very low. Fortunately, you will have to do only 1-click more to see the cartoon image, it is legit and it is free using GoComics.com, Dilbert.com and EdmontonJournal.com.

---------

Saturday News

Contents of This Week Saturday News:

• Headline - Decompressive Craniectomy

Decompressive craniectomy (crani- + -ectomy) is a neurosurgical procedure in which part of the skull is removed to allow a swelling brain room to expand without being squeezed. It is performed on victims of traumatic brain injury and stroke. Use of the surgery is controversial. A definition from Wikipedia and video clips from YouTube / Vimeo.

• Eclectic - Many articles from many Guest Bloggers about Stroke
• Putting the Possibility in Disability
• Hemicraniectomy for Massive Middle Cerebral Artery Infarction: A Review
• Cranio-What?
• Craniotomy vs. Craniectomy
• Six Top Clinical Trials in Traumatic Brain Injury (TBI)
• In the Limelight, Part 2
• My Upcoming Surgery for Foot Drop, aka My 50/50 Gamble
• Don't Worry, Therapists...
• Emotions and Attitude, Complexities of #50shades of Emotions
• Technology & #Strokerecovery Tweetchat – Your Views!
• Singing and Speaking Aphasia Speech Therapy
• The Stress of Aphasia and Recovery
• PoNS Inspired Therapy
• Blog for April 14 Stroke Recovery Tweet Chat: Patient Engagement
• What is an Engaged Patient?
• Weekly Columnists
• Musing: Severe Brain Injury Warrants Bold Moves
• Sunday Stroke Survival: Holes in Your Head? Brains Leaking Out
• Caregiver: Home Again, Home Again, Jiggity Jig!
• Jackie The Jester: Fossil Fuel Divestment Protester
• TED Talks - Henry Markram: A Brain in a Supercomputer
• Rick Mercer Report: Rick and Trapshooting
• Laid-Back Administration: Just a Minor Updated (Again!)
• Daily Comics: FB Or FW, Dilbert, Mayes, Doonesbury

Definition: Decompressive Craniectomy

Decompressive Craniectomy
      From Wikipedia, the free encyclopedia

A large decompressive craniectomy
is removed and the dura is opened
to allow the brain to expand.

Decompressive craniectomy (crani- + -ectomy) is a neurosurgical procedure in which part of the skull is removed to allow a swelling brain room to expand without being squeezed. It is performed on victims of traumatic brain injury and stroke. Use of the surgery is controversial.

The procedure evolved from a primitive form of surgery known as trephining or trepanning. The older procedure, while common in prehistoric times, was deprecated in favor of other, less invasive treatments as they were developed; although it was still performed with some frequency prior to the twentieth century, its resurgence in modern form became possible only upon the development of precision cutting tools and sophisticated post-operative care such as antibiotics.

Results of Clinical Trials

Reduction of Intracranial Pressure

Though the procedure is considered a last resort, some evidence suggests that it does improve outcomes by lowering intracranial pressure (ICP), the pressure within the skull. Raised intracranial pressure is very often debilitating or fatal because it causes compression of the brain and restricts cerebral blood flow. The aim of decompressive craniectomy is to reduce this pressure. The part of the skull that is removed is called a bone flap. A study has shown that the larger the removed bone flap is, the more ICP is reduced.

DECRA Trial

Video: Decompressive Craniectomy

Craniotomy and Craniectomy

Published on Jan 7, 2014 

 View more NUCLEUS medical animations at http://www.nucleuslibrary.com.

If you like this animation, LIKE us on Facebook: http://www.nucleusinc.com/facebook.

http://www.nucleusinc.com/medical-animations This 3D medical animation depicts two operations, called craniotomy and craniectomy, in which the skull is opened to access the brain. The normal anatomy of the skull and tissues surrounding the brain are shown, including arteries and veins. The animation lists the common reasons for these procedures, and briefly introduces intracranial pressure.

Transcript:

• Your doctor may recommend a craniotomy or a craniectomy procedure to treat a number of different brain diseases, injuries, or conditions.
• Your skull is made of bone and serves as a hard, protective covering for your brain.
• Just inside your skull, three layers of tissue, called meninges, surround your brain. 
• The thick, outermost layer is the dura mater.
• The middle tissue layer is the arachnoid mater and the innermost layer is the pia mater.
• Between the arachnoid mater and the pia mater is the subarachnoid space, which contains blood vessels and a clear fluid called cerebrospinal fluid.
• Blood vessels, called bridging veins, connect the surface of your brain with the dura mater.
• Other blood vessels, called cerebral arteries, bring blood to your brain.
• Inside your skull, normal brain function requires a delicate balance of pressure between the blood in your blood vessels, ... the cerebrospinal fluid that surrounds your brain, ... and your brain tissue.
• This is called normal intracranial pressure.
• Increased intracranial pressure may result from:
• brain tumours, 
• head injuries, 
• problems with your blood vessels, 
• or infections in your brain or spinal cord. 
• These conditions put pressure on your brain and may cause it to swell or change shape inside your skull, which can lead to serious brain injury.
• Your doctor may recommend a craniotomy to remove:
• abnormal brain tissue, such as a brain tumor,
• a sample of tissue by biopsy,
• a blood clot, called a hematoma, 
• excess cerebrospinal fluid, 
• or pus from an infection, called an abscess. 
• A craniotomy may also be done to: 
• relieve brain swelling, 
• stop bleeding, called a hemorrhage, 
• repair abnormal blood vessels, 
• repair skull fractures, 
• or repair damaged meninges. 
• Finally, a craniotomy may also be done to: 
• treat brain conditions, such as epilepsy, 
• deliver medication to your brain, 
• or implant a medical device, such as a deep brain stimulator. 
• The most common reason for a craniotomy is to remove a brain tumor.

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Eclectic Stuff

Definition: Eclectic(noun) a person who derives ideas, style, or taste from a broad and diverse range of sources.

Putting the Possibility in Disability

Jackie Poff
Stroke Survivors Tattler

Friday, November 11, 2011

SSTattler: Re-published Nov/11 2011 -- Thanks Jackie for a
                   great article!

by Jackie Poff

Some stroke survivors remember vividly their strokes and the events leading up to and around their strokes. I personally remember very little about my stroke – thankfully!

It has been three and one half years since my stroke, which took place on a very cold morning in January 2008. But here is what I do know about that day. On January 22nd (the day before my stroke) I was taking advantage of my lunch hour at work by taking with me my daughter, Nicole, who I had had the great pleasure of hiring onto my staff. We headed out to start apartment hunting for her. I received a phone from my mother informing me that my grandfather, Jack, who I was named after, had passed away at ninety years old.

That evening our family gathered at grandpa’s house in Tofield to discuss his passing. We arrived back home on our acreage near Spruce Grove much later than we intended. We all crawled into bed exhausted and I, as always, slept like a log.

I did remember to set my alarm for 6:30 in order to give Michelle, our youngest daughter, then thirteen, a ride to school for an early morning handball practice. When the alarm went off, I stumbled out of bed and went to the bathroom to run a brush through my hair. My husband Larry, a light sleeper, followed me and asked me why I was up so early. As he questioned me, suddenly my words became gibberish and I started to fall over. Larry, wondering what the heck was going on, caught me and rushed me to our bed. I was not responding. Nothing I did or said made any sense.

Larry recognized that I must be having a stroke. He managed to call our families and yell to the kids. He threw me in the car and got me to the nearest hospital, the Sturgeon Hospital in St. Albert.

There a CT scan confirmed I was having a massive MCA Stroke. TPA was administered within the 3 hour window. However, the TPA did not work and I was rapidly losing function.

Hemicraniectomy for Massive Middle Cerebral Artery Infarction: A Review

Jackie Poff
Stroke Survivors Tattler

Can. J. Neurol. Sci. 2008

Dulka Manawadu, Ahmed Quateen, J. Max Findlay

ABSTRACT: Hemicraniectomy and opening underlying dura mater permits the expansion of infarcted, swollen brain outwards, reversing dangerous intracranial pressure elevations and the risk of fatal transtentorial temporal lobe or diencephalic herniation. Recently published randomized controlled trials have proven this procedure a powerful life-saving measure in the setting of malignant middle cerebral artery infarction and allayed concerns that a reduction in mortality is accompanied by an unacceptable increase in patients suffering severe neurological impairments. Appropriate patients are relatively young, in the first five decades of life, suffering infarction of a majority of the middle cerebral artery (MCA) territory in either hemisphere, and decompression should be performed prior to progression to coma or two dilated, fixed pupils. Lethargy combined with midline shift and uncal herniation on neuroimaging is an appropriate trigger to consider and discuss surgical intervention. Families and, when possible, patients themselves, should be informed of the certainty of at least moderate to mild permanent deficits, and the possibility of worse. To be successful decompression must be extensive, targeting a bone flap measuring 14 cm from front to back, and extending 1 to 2 cms lateral to the midline sagittal suture to the floor of the middle cranial fossa at the level of the coronal suture. An augmentation duraplasty is mandatory.



See the full article:
      Hemicraniectomy for Massive Middle Cerebral Artery Infarction: A Review

Cranio-What?

Grace Carpenter
My Happy Stroke

Monday, September 13, 2010

One of the specialists we saw last week was looking over the notes about my stroke and said, "I see you had a craniotomy."

Craniotomy?

I know that I had brain surgery, but I didn't realize that it's called a craniotomy. The image that comes to mind for me is a slightly unbalanced Victorian surgeon, indulging his curiosity by drilling holes willy-nilly in his patient's skull (apologies to the fabulous Dr. Tierney).

I'm sure this procedure has come a long way since the Victorian times, especially at MGH. Still, I'm glad that I wasn't awake during the operation.

See the original article:

Cranio-What?

in

My Happy Stroke

Craniotomy vs. Craniectomy

Amy Shissler
My Cerebellar Stroke Recovery

November 21, 2012

Recently I was asked about my brain surgery.  I had a craniectomy.  Actually my surgery was called a Decompressive Craniectomy.  But I said the word ‘craniotomy’ when I was asked about it.  I figure I got it mixed up, so I bet other people do too.  Otomy means opening.  Ectomy means removal.  So they open the skull in a craniotomy, and remove a part of the skull in a craniectomy.  It’s basically the same surgery, the end is just different.  A piece of skull is removed to allow access to the brain.  The difference is that in a craniotomy the doctors do what they need to do and then that piece of bone is replaced.  In a craniectomy, that bone is not replaced because of all of the swelling.  Sometimes in a craniectomy that bone is replaced later on, but not in my case.  That bone will never be replaced.  I used to be really, really freaked out by this.  I thought it meant my brain was just exposed.  It’s not.  They did the craniectomy in a spot where the muscle covering my brain is like an inch thick.  It’s still weird, but I’m not freaked out by it anymore.  Sometimes however, it hurts when people give me a hug in the wrong spot and squeeze.  If I hug someone our arms have to be low, it’s weird, I hate hugging like a normal person.  I always say to my friend Mandy, well “back when I was normal…..”  This makes her laugh.  I do what I can.  I’m not sure what this means and I’m not sure I want to know.  I don’t know why it hurts sometimes and have never asked anyone.  I don’t want to hear something like “because your brain has pressure on it.”  I’m better off not knowing the reason.  I have read that craniectomies are often the source of more headaches because the theory is that those muscles are working a lot harder since there is no longer bone there.  I’m not sure if I really believe this is the reason for more headaches, but whatever.  Good thing I know what I know about posture and headaches.

Related articles:

• Doctors Store Skull In Woman’s Stomach For 42 Days Following Brain Surgery (seattle.cbslocal.com)

See the original article:

Craniotomy vs. Craniectomy

in

My Cerebellar Stroke Recovery