Dear Readers,

Welcome to NeuroAiD's January 2009 Newsletter. The idea of this monthly release is to share vital information for stroke patients and their families, and help them deal successfully with the common challenges life presents after a stroke.

This month, we are going to talk about age-related diseases and stroke, as stroke could occur at any age but predominantly affects the elderly, in which population the incidence of osteoporosis and vision deficit is high. Following a stroke, in addition to any age-linked unfavourable conditions previously that may have been pre-existing, a patient may suffer more from this problems. Today we will analyse the relation between these diseases and stroke and find you a solution to struggle against them therefore regain a healthier body.

We want this to be more than a one-way communication, and would be most happy to hear back from you. What you have experienced and learned will be very valuable to others and we will make sure it reaches as many people in our community as possible. Do also let us know what topics you wish to read in future issues of your NeuroAiD's newsletter.

We would like to assist you in your return to daily life while recovering from stroke. As you are probably already aware, making the best use of time is of vital importance in your stroke recovery. Therefore, please allow us to call you at a number, day and time of your convenience, to hear your questions and explain our answers. If you agree, kindly email us the table below at info@neuroaid.com :

• Number :
• Date :
• Location / time zone :
• Person to ask for :

If you choose to contact us yourself instead, call us on our US toll free number:
1-800-882-4046 / +65-6478-9430 or email us at info@neuroaid.com.

The NeuroAiD™ Team at Moleac

Vision is the process of deriving meaning from what is seen. It is a complex, learned and developed set of functions that involve many skills & abilities. Research estimates that 80%-85% of our perception, learning, cognition and activities are mediated through vision. The association between vision impairment and disability in activities of daily living (ADLs) has been well established and widely recognized.

As increased age relates to increased incidence of stroke, many people who suffer from stroke may also have pre-existing age-related visual deficits. Following a stroke, a patient may suffer from additional visual deficits in addition to any age-linked unfavourable conditions previously that may have been pre-existing. The visual changes associated with stroke can be categorized as sensory (visual acuity and visual field), motor (extra ocular muscle motility), and perceptual.

For instance, hemianopia, or loss of visual field on one side, is a result of a stroke and is detected after 36% of right brain strokes and 25% of the left brain strokes. Following a stroke, changes in the visual field can include absolute versus relative loss or constriction. With a lesion in the brain disrupting the visual pathways, a person’s ability to take the entire visual field may be interrupted. Deficits in the quantity of what our eyes can perceive are referred to as deficits in our visual field.

The Testing of a possible vision deficit includes knowing where straight ahead is, knowing where things really are located, reduction & frequently correction of double vision and the ability to have a person's eyes land on the right spot when reading or looking around the environment. This contributes to balancing problems. If you or a loved one has had a stroke or head injury, you need this type of evaluation and treatment to improve recovery and perhaps even drive again.

Do you or a person you know suffer from any of the following symptoms?

• Double vision
• Headaches
• Blurry vision
• Dizziness or nausea
• Attention or concentration difficulties
• Staring behaviour (low blink rate)
• Spatial disorientation
• Lose place when reading
• Can't find beginning of next line when reading
• Comprehension problems when reading
• Visual memory problems
• Pulling away from objects when they are brought close
• Disturbance of behavioural or emotional functioning
• Partial or total functional disability
• Physiological maladjustment
• Visual dysfunction

Vision impairment is one of the most commonly overlooked and under-treated conditions of the elderly and those who have had traumatic brain injury or stroke. However, vision rehabilitation after a stroke is worthwhile and often necessary for a stroke or brain injury survivor to enjoy a normal life. Neuroaid gives a good add-on treatment to enhance the rehabilitation. In a recent case study of 10 patients post-stroke under Neuroaid, published on European Neurology, significant improvements were recorded in visual.

On the other hand, vision therapy can be a very practical and effective. After evaluation, examination and consultation, the doctor determines how one person processes information after a stroke, and where that person‘s strengths and weaknesses lie. Then he or she prescribes you a treatment regimen incorporating lenses, prisms, low vision aides and specific activities designed to improve control of your visual system and increase vision efficiency. An interesting video can give you an idea on how it works: view YouTube Video

For hemianopia, on average Vision Restoration Therapy can help recover a 5 degree border shift (or 12% improvement in stimuli accuracy) in the central visual field. This 5 degree border shift can make a significant impact in the daily lives of patients: Indeed, seeing more is better!

Sources:

helpforvisionloss.com

Stroke Rehabilitation Journal

Youtube

Stroke could occur at any age but predominantly affects the elderly. Therefore, the population at the highest risk of stroke is also at a high risk of experiencing osteoporosis. An osteoporosis is a disease of bone that leads to an increased risk of fracture. After stroke, there are many factors which contribute to the loss of bone mineral density (BMD) and fracture. A BMD is a bone mineral density (BMD) test that measures the density of minerals (such as calcium) in your bones using a special X-ray, computed tomography (CT) scan, or ultrasound. This information is used to estimate the strength of your bones.

Why stroke could lead to a higher risk of osteoporosis? The exact mechanism which is responsible for the reduced BMD observed on the hemiplegic side after stroke has not been yet fully understood until now. In 2000, five Japanese scientists have demonstrated that immobilization following acute hemiplegia enhances bone resorption, and it increases inonized serum calcium levels. Later, in the course of stroke, factors such as the degree of functional recovery, duration of the hemiplegia, reduced vitamin D and anticoagulation with warfarin may contribute to ongoing bone loss. After a stroke, these factors cited above contribute to the loss of BMD and fracture. Therefore, a pre-stroke low BMD and vertebral fracture may add to the risk of osteoporosis and fracture, as well as further contribution to additional functional loss. Also, in a consideration that osteoporotic vertebral fractures share some risk factors with stroke such like reduced physical activity, excessive alcohol consumption, smoking and poor calcium intake, etc.

Stroke itself already brings a lot of physical and emotional burden to the patient and family members. These problems, such as osteoporosis could easily be ignored as minor secondary issues. What is more, among the various kinds of osteoporotic fractures, vertebral fractures are the most common worldwide. Unlike hip fracture, many vertebral fractures are asymptomatic and go undetected. However, these do not give reason to less awareness, it is imperative that these conditions are managed adequately from the very beginning stage of stroke and that preventive measures are undertaken simultaneously. It is also important to provide not only patients but also caregivers with adequate information on clinical consequences of osteoporosis and on the subsequent risk of fracture, and to call for their active participation in its prevention and treatment.

A special attention should be paid concerning the nutrition. A diet high in protein (acids) and salt but low in potassium might aggravate osteoporosis and increase risk of stroke. Potassium is the seventh most plentiful mineral on earth. More potassium, say experts, would help protect us against high blood pressure, strokes, kidney stones, and bone loss.

Sources:

Bone Journal

American Heart Association

Mark Andrews (UK)

"My mother suffered from a stroke and was in hospital and rehabilitation for 4 months and a half. At a board meeting prior to discharge, officials informed me that she had made very little progress and would never walk again. As a consequence a sling hoist was deemed necessary to make all transfers with two carers always present for these transfers.

I did some research on the internet and decided to give NeuroAiD™ a try. During the three months following her discharge she began to weight bear again, and has now progressed to walking on a zimmer frame. The hoist is no longer used, and only one carer required. All have commented how much stronger she is now. As this improvement only happened since taking NeuroAiD™ (many people were praying for her as well), I would definitely recommend NeuroAiD™ as a valuable resource in stroke recovery."

In the past decade, numerous attempts focusing on neuroprotective strategies have been made to rescue neurons in the ischemic brain. Within few hours of an ischemic stroke event, acute injuries are often irreversible. The future point will be focused on how the brain tissues could be repaired. Recently, transplantation of embryonic and adult stem cells has provided new hope to stroke survivors.

The essential players in this rescue mission, stem cells, are characterized by the ability to renew themselves through mitotic cell division and differentiate into a diverse range of specialized cell types. Stem cells can now be grown and transformed into specialized cells with characteristics consistent with cells of various tissues such as muscles or nerves through cell culture.

Six years ago, scientists showed that stem cells had promise in treating strokes. They tracked the body's own stem cells during brain repair; learned how to target stroke-damaged regions… This year, a new experience is carried in Stanford University on ten stroke-crippled rats with neurons grown from human embryonic stem cells. Scientists observed that the new neurons gathered in damaged brain regions, connecting to healthy cells and to each other. Within weeks the rats could again control their weakened legs.

Though the results are preliminary, it offers a glimmer of hope to millions of people left brain-damaged or crippled by strokes. However, before that can happen, scientists need to refine their methods of encouraging stem cells -- either embryonic, as in this study, or adult -- to reliably form neurons that don't turn cancerous. This will still take many years.

Sources:

Stem Cells Journal

PLoS One

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