Some of you have seen this video going around, claiming you can save someone suffering from stroke injury using a needle. The idea behind this video, according to HealthyChoices365, is that a Chinese “professor” claimed this will save the person’s life following a stroke.
This is kind of the thing that, as a basic scientist in the field, boils me for the last few days. First, it is plain quackery. The needle prick has nothing to do with the stroke event: it is distal from the site to have an effect. Second, using this technique on a patient has a direct impact on the patient’s stroke outcome and recovery. Let me explain why this is bullshit and should be called for what it is: A gazillion pile of bullshit that has much more weight that all the coal West Virginia has and had since the geological formation of that region (no pun intended, W. Va has one of the highest number of stroke per capita in the US, since it is Xmas season the lump of coal is simply appropriate).
In brief, stroke is the 5th cause of death in the US (3rd amongst women) and a leading cause of disability. We have two types of stroke: ischemic (85%) and hemorrhagic (15%) with the later accounting for 40% of stroke-related deaths. We estimate that about one US citizen will experience a stroke event every 5 minutes.
1. Stroke 101: Back to basics
In the ischemic stroke, we have a clot (usually formed at the carotid artery bifurcation) that is formed due to the presence of atherosclerotic plaques. These plaques can become unstable and crumble over time. These crumbles are made of clot that navigate through the carotid artery that irrigate the brain. Such clot will act as a plug or a cap, once it reaches a vessel with a diameter smaller than the clot, it will occlude it and block the blood flow.
This create what we call an ischemic situation. In such ischemic situation, the brain is deprived of both oxygen (20% of all oxygen is wired to the brain) and nutrient (in particular, glucose. The brain accounts for about 25% of the total glucose level utilization in the whole body). Neurons are the most sensible brain cells to stroke injury. They cannot adapt to hypoxia (lack of oxygen). Few minutes of hypoxia is enough to cause severe and irreversible brain damage. We estimate about 1 million neurons die every minutes that a stroke is left untreated.
Furthermore, neurons are post-mitotic cells. They cannot divide anymore. When a neuron is gone, it is gone, as well as its neuronal circuitry. You see, each minute matters because what is lost is lost.
Stroke signs can be resumed by the “FAST” acronym: Face droop, Arm weakness, Speech issues, Time to call 911. By the time you are showing signs, it has been already a couple of hours your brain has been starving off glucose and oxygen. It is important that once you have the signs to call 911 and asked the paramedics to direct you to the closest stroke center.
The most important thing to happen in stroke diagnosis is to determine which type of stroke the patient is undergoing: ischemic or hemorrhagic? These two are very different and confusing one with another can have a deadly effect. You don’t want to give a clot-buster to someone with hemorrhagic stroke because it will make the bleeding worse. You don’t want to give a clotting agent to a patient with ischemic stroke because you will increase the risk to develop a second stroke.
The current procedure is the use of endovascular intervention: the neurosurgeon insert a catheter in the femoral artery and using an angiography method to see blood vessels “live on screen” reach the site of stroke injury to either remove the clot or to put a stent in place to stop the bleeding process. From discussing with a physician, this takes about 10-15 minutes once the patient is in the OR.
2. Why this video is BS and should be called BS:
Now, lets see why I call this video BS.
First, the idea of finger prick to treat stroke is BS. We are trying to act on the stroke from a remote site. The thing is, the clotting process occurs in a very local fashion. So trying to act on a stroke with pricking a finger with a needle is mostly useless.
Second, as I said, it is important to know which type of stroke we are treating. You cannot identify which type of stroke is involved just by the clinical signs. You need imaging (CT scan or MRI) to be able to distinguish ischemic stroke from hemorrhagic stroke.
Third, this useless procedure is a formidable waste of time on the patient. As we said, each minute lost is a precious minute lost that will condition the outcome and the recovery. How long should we waste before calling 911 because we noted no improvement: 15 minutes? 30 minutes? 60 minutes? By the time the patient realized this intervention is bogus, his/her chance to survive and recover from the stroke injury are almost close to zero.
To conclude, let me finish this post with a call: PLEASE! PLEASE! PLEASE! Whenever you or a loved one is showing the FAST signs, CALL 9-1-1!!!! Know your nearest hospital with a certified Stroke Center and have the paramedics bring you there. THERE IS NO THERAPY FOR STROKE! OUR BEST BETS ARE PREVENTION (80% of stroke events can be prevented) AND INTERVENTION (by keeping the “door-to-bed” to a minimum).
The Blood-Brain Barrier Scientist 