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Coffee, sex and blowing your nose could increase the risk of a type of stroke, say researchers in the Netherlands. The study on 250 patients identified eight risk factors linked to bleeding on the brain. They all increase blood pressure which could result in blood vessels bursting, according to research published in the journal Stroke. The Stroke Association said more research was needed to see if the triggers caused the rupture. More than 150,000 people in the UK have a stroke each year with nearly 29,000 due to bleeding on the brain. Bleeding can happen when a weakened blood vessel, known as a brain aneurysm, bursts. This can result in brain damage or death. The researchers at the University Medical Center in Utrecht looked at 250 patients for three years to identify what triggers ruptures.
Caffeine danger
They found that coffee was responsible for more than one in 10 burst brain aneurysms. While people drinking coffee had only a 1.7 times greater risk, it is more common than other risk factors. Being startled increased the risk by more than 23 times, but was responsible for just 2.7% of cases. Dr Monique Vlak, a neurologist and the study's lead author, said: "All of the triggers induce a sudden and short increase in blood pressure, which seems a possible common cause for aneurysmal rupture."
Lower risk
The authors said one in 50 people has a brain aneurysm, but only a few rupture. Dr Vlak advised that: "Reducing caffeine consumption or treating constipated patients with unruptured intracranial (brain) aneurysms with laxatives may lower the risk of subarachnoid haemorrhage." The study only looked at the triggers for the burst. High blood pressure weakens blood vessels in the first place and can be caused by being overweight, smoking and a lack of exercise.
Dr Sharlin Ahmed, Research Liaison Officer at The Stroke Association said: "A sudden surge in high blood pressure can increase the likelihood of an aneurysm rupturing. However, it's very difficult to determine whether the triggers identified in this study are definitely related to the onset of a stroke as they could simply be put down to coincidence. "A lot more research needs to be carried out to assess whether each of the identified triggers could directly cause an aneurysm to rupture."
BBC News - Sex and coffee 'trigger stroke'
Scientists in the Netherlands are using robotic legs to try to improve the movement of stroke patients. The prototype device is called the Lower-extremity Powered ExoSkeleton, or LOPES, and works by training the body and mind of a patient to recover a more natural step. The machine is also being tested on spinal injury patients who have recovered some restricted movement in their legs. It is hoped a commercial version could be made available to rehabilitation centres around the world as early as next year.
Feedback mechanism
LOPES has been developed by engineers at the University of Twente in Enschede in the Netherlands over several years. Designed for the rehabilitation clinic, it is not a mobile device but supports the patient as they walk on a treadmill. It can do all the walking for the patient, or it can offer targeted support in either one leg or with one element of the walking process. The machine can also detect what the patient is doing wrong. "For instance, some people cannot lift their foot up appropriately," explains Dr Edwin van Asseldonk, who is working on the project. "What this device does is it senses that the foot is not lifting properly. "It then compares it with a reference pattern and then exerts a force or torque to assist that subject in doing it."
Petra Hes is one of those testing the device. She suffered a stroke aged just 17. Years of physiotherapy have helped, but she still has what is known as a "drop foot", which means she cannot lift and flex her left foot in the way she once did, or even remember how to do so. The machine provides the forces to enable her to physically move her left leg and foot the way it should move, but it also operates as a memory aid, the researchers believe. "I got a eureka moment because I felt an old feeling of how to walk normally," she recalls of the first time she used the machine. "That push-up I felt and my knee lifting it is what I've forgotten. I couldn't reproduce it myself so I had to feel it again."
Dr van Assledonk believes that by physically showing patients how to walk properly, the machine can help them develop the brain signals required to drive improved movement. "With stroke survivors, it's very important that they get signals to the brain but also that they send signals downwards from the brain," he says. "It's only when you get information from your legs to your brain and vice-versa that can you hope for some plasticity in your brain." Dr Sharlin Ahmed from The Stroke Association in the UK hopes the innovation will help. "Mobility issues have negative effects upon stroke survivors' quality of life, so we welcome any research or technology that will help improve mobility for stroke survivors and enable them to have a better quality of life," she told the BBC.
Military exoskeletons
One study review found that eating an extra two to three servings of fruit or vegetables per day - which are high in potassium - was beneficial. A lower salt intake would increase the benefits further, researchers said. A stroke charity said a healthy diet was key to keeping stroke risk down. While the increase of potassium in diets was found to have a positive effect on blood pressure, it was also discovered to have no adverse effects on kidney function or hormone levels, the research concluded.
Fruit, such as bananas, and most vegetables and pulses are high in potassium
As a result, the World Health Organisation has issued its first guidelines on potassium intake, recommending that adults should consume more than 4g of potassium (or 90 to 100mmol) per day. The BMJ study on the effects of potassium intake, produced by scientists from the UN World Food Programme, Imperial College London and Warwick Medical School, among others, looked at 22 controlled trials and another 11 studies involving more than 128,000 healthy participants.
The results showed that increasing potassium in the diet to 3-4g a day reduced blood pressure in adults. This increased level of potassium intake was also linked to a 24% lower risk of stroke in those adults. Researchers said potassium could have benefits for children's blood pressure too, but more data was needed.
Salt solution
I dunno...
... mebbe plums?...
... good catch.
Potassium is also good for muscle cramps...
Increase potassium and cut salt to reduce stroke risk
4 April 2013 - Increasing potassium in our diets as well as cutting down on salt will reduce blood pressure levels and the risk of stroke, research in the British Medical Journal suggests.
One study review found that eating an extra two to three servings of fruit or vegetables per day - which are high in potassium - was beneficial. A lower salt intake would increase the benefits further, researchers said. A stroke charity said a healthy diet was key to keeping stroke risk down. While the increase of potassium in diets was found to have a positive effect on blood pressure, it was also discovered to have no adverse effects on kidney function or hormone levels, the research concluded.
Fruit, such as bananas, and most vegetables and pulses are high in potassium
As a result, the World Health Organisation has issued its first guidelines on potassium intake, recommending that adults should consume more than 4g of potassium (or 90 to 100mmol) per day. The BMJ study on the effects of potassium intake, produced by scientists from the UN World Food Programme, Imperial College London and Warwick Medical School, among others, looked at 22 controlled trials and another 11 studies involving more than 128,000 healthy participants.
The results showed that increasing potassium in the diet to 3-4g a day reduced blood pressure in adults. This increased level of potassium intake was also linked to a 24% lower risk of stroke in those adults. Researchers said potassium could have benefits for children's blood pressure too, but more data was needed.
Salt solution
Prof Keith Muir, of Glasgow University, who is treating them, says he is "surprised" by the mild to moderate improvements in the five patients. He stresses it is too soon to tell whether the effect is due to the treatment they are receiving. The results will be presented at the European Stroke Conference in London.
Complete paralysis
BBC News has had the first exclusive interview with one of the patients involved. They are taking part in a small clinical trial involving nine patients in their 60s, 70s and 80s at Glasgow's Southern General Hospital to assess the safety of the procedure which involves injecting stem cells into the damaged brain part. It is one of the first trials in the world to test the use of stem cells in patients. Results to be presented on Tuesday show that there have been no adverse effects on the patients so far and there have been improvements to more than half participating in the trial.
However, at this stage it is not possible to say whether the improvements are due to the close medical attention the patients are receiving. It is well documented that the feeling of wellbeing resulting from such attention, known as the placebo effect, can have a positive effect on people's health. But it is thought that stroke patients do not recover after the first six months of their stroke. All the patients involved in the trial had their strokes between six months and five years before they received the treatment.
The recovery of any one of them - let alone five - was not expected, according to Prof Muir, who is in charge of the trial. "It seems odd that it should all just be chance and a placebo effect," he told BBC News. "We are seeing things that are interesting and somewhat surprising. "We've seen people who now have the ability to move their fingers where they have had several years of complete paralysis," Prof Muir said. "We have seen some people that have been able to walk around their house whereas previously they had been dependent on assistance and we have had improvements that have enabled people to recognise what is happening around them."
'Temporary change'
The devices regularly squeeze the legs to keep blood flowing and prevent formation of fatal blood clots. A trial with 2,876 patients, published in the Lancet, showed there were fewer clots with the wraps. The Stroke Association said the results were "extremely encouraging" and had the potential to save thousands of lives.
Bleeding on brain
A clot in the leg, a deep vein thrombosis, is normally associated with long flights, but is a problem for hospital patients unable to move. Around 60,000 people a year in the UK are immobile when admitted to hospital after a stroke. Doctors at Western General Hospital and the University of Edinburgh said compression socks did not improve survival and clot-busting drugs led to other problems, including bleeding on the brain. They tested the devices, which fit around the legs and fill with air every minute. They compress the legs and force the blood back to the heart. They were worn for a month or until the patient recovered and was able to move again.
The wraps inflate to move blood through the legs
'Reduces the risk'
In the study, 8.5% of patients using the compression device developed blood clots, compared with 12.1% of patients who were treated normally. Prof Martin Dennis said: "At last we have a simple, safe and affordable treatment that reduces the risk of deep vein thrombosis and even appears to reduce the risk of dying after a stroke. "We estimate that this treatment could potentially help about 60,000 stroke patients each year in the UK. "If this number were treated, we would prevent about 3,000 developing a deep vein thrombosis and perhaps save 1,500 lives." He said the system should also be tested in other immobile patients, such as those with pneumonia.
'Incorporate into clinical guidelines'
Prof Tony Rudd, who chairs the Intercollegiate Stroke Guideline Group at the Royal College of Physicians, said: "This study is a major breakthrough showing how a simple and safe treatment can save lives. "It is one of the most important research studies to emerge from the field of stroke in recent years." Dr Dale Webb, of the Stroke Association charity, said: "The results of this research are extremely encouraging and show that using a compression device on the legs of patients at risk of developing blood clots could be a more effective treatment. "This new device has the potential to save thousands of lives and we would like to see it incorporated into national clinical guidelines."
BBC News - Leg wraps raise hopes of saved lives after strokes
