YOUR BRAIN/INNER SANTUM VECTOR N360™

INNER SANCTUM

THE BRAIN

SPECIAL EDITION

V E C TOR

N360

©™

Neurosurgeon RAFAEL RODRIGUEZ-MERCADO MD, FAANS, FACS !

“It’s the responsibility of a Technology Publication to share new ideas and challenge the status quo.

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And when a Publication fails to include different experiences, beliefs, and ideas, they miss out on a true perspective of Our Global Environment.”

Linda Restrepo Editor/Publisher

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BRAIN ATTACK:

TIME IS BRAIN

AND BRAIN IS TIME! !

RAFAEL

RODRIGUEZ-MERCADO MD, FAANS, FACS !

800,000 STROKES IN THE U.S.

5th

MOST COMMON CAUSE OF DEATH IN THE US

3 STROKE CAUSES A DEATH EVERY 3 MINUTES 30 SECONDS

160,264

STROKE DEATHS PER YEAR

ENDOVASCULAR TREATMENT OF CEREBRAL ANEURYSMS WITH IN THE US COILS

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M E S S A G E

MESSAGE! LOOK FOR HELP AS SOON YOU GET STROKE SYMPTOMS THE SOONER YOU LOOK FOR HELP THE BEST RESULTS YOU GET

ENDOVASCULAR TREATMENT OF CEREBRAL ANEURYSMS WITH COILS

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Stroke is the 5th leading cause of death in the USA with 160,264 deaths per year.

There are approximately 800,000 strokes per year in the USA. Strokes represent the leading cause of disability and are the most preventable disease. The annual cost of treating patients with stroke in the US exceeds 62 billons dollars per year.

There are two types of strokes ischemic and hemorrhagic.

Approximately 85% of the strokes are ischemic where a blood vessel of the brain is obstructed by a blood clot or atherosclerotic plaque producing a neurological deficit distal to the area of occlusion. The main causes of ischemic stroke are smoking, atrial fibrillation, high blood pressure, obesity, diabetes, atherosclerotic disease, Covid-19, oral contraceptives, and hematological causes among others. Hemorrhagic strokes represent 15% of all strokes and are related to hypertension, brain aneurysm, and vascular malformations that produce acute bleeding due to rupture of the brain vessels.

Regarding ischemic stroke, the symptoms can present with a sudden episode of weakness in one side of the face, arm, or leg associated with slurred speech. When the symptoms last less than 24 hours we called a transient ischemic attack (TIA) or “mini-stroke” which is caused by a temporary disruption in the blood supply to part of the brain.

The disruption in blood supply results in a lack of oxygen to the brain. This can cause sudden symptoms like a stroke, such as speech and visual disturbance, and numbness or weakness in the face, arms, and legs.

The main symptoms of a TIA can be remembered with the word FAST:

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• F A C E – the face may have dropped on 1 side, the person may not be able to smile, or their mouth or eye may have dropped.

• A R M S – the person may not be able to lift both arms and keep them raised because of weakness or numbness in 1 arm.

• S P E E C H – their speech may be slurred or garbled, or the person may not be able to talk at all, despite appearing to be awake; they may also have problems understanding what you're saying to them.

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*** T I ME

it's time to call 911

immediately if you see any of these signs or symptoms.

A TIA is often a sign that another one may follow, and you are at a high risk of having a full, life-threatening stroke soon.

We must remember that there are several ways you can lower your risk of having either in the future as maintaining a healthy weight, eating a healthy, balanced diet, doing regular exercise, limiting alcohol, and not smoking.

Hemorrhagic strokes present with a severe headache that is described as the worst one in their life. However, generalized symptoms, including nausea, vomiting, and headache, as well as an altered level of consciousness, may indicate increased intracranial pressure and are more common with hemorrhagic strokes and larger ischemic strokes.

Seizures are more common in hemorrhagic stroke than in the ischemic kind.

The causes of hemorrhagic strokes are high blood pressure, cerebral aneurysms, and cerebral vascular malformations.

According to many extensive studies, the overall mortality rate 30 days after an ischemic stroke was 19 percent, with the one-year survival rate for these patients being approximately 77 percent.

However, it is important to note that prognosis after an acute ischemic stroke can vary greatly from patient to patient, having many variable factors such as stroke severity, premorbid conditions, age, and post-stroke complications.

The prognosis for a hemorrhagic stroke is dependent on the severity of the stroke. As mentioned, hemorrhagic stroke has a high death rate, so immediate medical treatment is the key to a positive prognosis.

Recovery may take months or even years and doctors will provide patients with a plan to follow when they go back home to ensure they reduce the risk of a future stroke occurring.

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Ischemic strokes are the most common kind of stroke. They occur when a blood clot blocks blood flow to your brain.

Medication treatment for this type of stroke must start within 4.5 hours of the event, according to 2018 guidelines from the American Heart Association (AHA) and the American Stroke Association (ASA). It aims to break up the blood clot that is blocking or disrupting blood flow in the brain.

Your doctor may also administer drugs to break up clots. A common intravenous (IV) drug is tissue plasminogen activator (tPA). It’s given during an active stroke if the person is a good candidate.

This medication works to stop a stroke by dissolving the clot that’s causing it.

After a stroke, your doctor may prescribe oral drugs, such as clopidogrel (Plavix) or blood thinners.

These are used to thin your blood to reduce the risk of stroke in the future.

Statins have also been shown to reduce the incidence of future stroke.

If drugs don’t adequately break up the blood clot and if the stroke is acute, or localized to one area, your doctor may use a catheter to access the clot and remove it manually.

The catheter is threaded through your blood vessels toward the area where the clot is lodged. Your doctor can remove the clot either by a corkscrewlike device attached to the catheter or by using clot-busting agents administered through the catheter directly into the clot.

Mechanical clot removals can be performed up to 24 hours after the appearance of stroke symptoms.

A large stroke can lead to serious swelling in the brain. In some cases, surgical intervention may be necessary if drugs don’t adequately relieve the swelling.

Decompressive craniectomy aims to relieve the buildup of pressure inside your skull before it becomes dangerous. For the procedure, your surgeon will open a flap of bone in your skull in the area of the swelling.

Once the pressure is relieved, the flap will typically be returned.

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Ischemic Stroke Endovascular Treatment With Stent Retriever

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Treatment of Ischemic Stroke with stent retriever !

Ischemic Stroke Endovascular Treatment With Aspiration Technique

Decompressive craniectomy for ischemic stroke which does not Respond to Medical or Endovascular Treatment !

AVM

AVM

AVM

AVM

Treatment of a cerebral Arteriovenous malformation with n-BCA (histoacryl)

AVM

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Aneurysm with Flow diverter

Aneurysm

Aneurysm

Aneurysm

Endovascular treatment of aneurysm with a flow diverter stent

Aneurysm

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Endovascular Treatment Of Cerebral Aneurysms With Coils

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In hemorrhagic strokes depending on the damage to the vessel in your brain, you may need surgery after a hemorrhagic stroke.

Another treatment option is clipping the aneurysm by permanently installing a clamp to prevent it from bleeding further or bursting.

For surgery to be performed successfully, the abnormal blood vessel must be in a location that the surgeon can reach.

This procedure involves surgery and is recommended when coiling won’t be effective.

If your surgeon can access the affected artery, they may remove it completely. Removal reduces the risk of a future rupture. Depending on the location and size of the aneurysm, surgical removal may not be a good option.

Your doctor may recommend a procedure called endovascular repair.

Your surgeon threads a thin wire and catheter through your blood vessels and into the aneurysm.

Then, they release a coil of soft platinum wire into the area or use a stent-assisted device or flow diverter stent. The wire is about as thick as a strand of hair. This coil creates a net that prevents blood from flowing into the aneurysm. This keeps it from bleeding or rebleeding.

Clipping is typically more invasive than coiling or stenting.

Rehabilitation following a stroke depends on the extent of the damage and what part of your brain was affected.

For instance, if the stroke occurred in the right side of your brain, you may need physical rehabilitation that focuses on walking up and down stairs, getting dressed, or bringing food to your mouth.

The right side of the brain controls visual-spatial functions.

You may need rehabilitation or corrective measures to also help with:

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COORDINATION BALANCE VISION BOWEL OR BLADDER CONTROL SPEECH SWALLOWING FINE MOTOR ACTIVITY, SUCH AS WRITING OR DRAWING

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As an ending statement stroke is on of the more decapacitating conditions in medicine and was stated before is on of the most preventable one. Knowing your family history of stroke, controling your blood sugar, exercising at least 30 minutes a day, and good blood pressure control among others can safe you from a stroke and if you have the signs and symptoms of a stroke remember brain is time and time is brain”.

Rafael RodriguezMercado MD, FAANS, FACS

DISCLAIMER: The information in this presentation is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment and should not be construed as such. All content including text, graphics, images and information contained is for general informational and educational purposes only. Always Consult with your personal physician for all medical advice.

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DIS !

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RAFAEL RODRIGUEZ-MERCADO MD, FAANS, FACS SECRETARY OF HEALTH FOR PUERTO RICO !

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Professor of Neurosurgery at the School of Medicine and Director of the Endovascular Surgery Program of this institution. He also leads the same program at ASEM Stroke Medical Center and, is the director of the Fellows Training Program in Neuroendovascular Surgery. In his extensive professional career stands out the realization of about 4,000 endovascular corrections in people with intracranial congenital vascular malformations.

He is author and co-author of 30 scientific articles in prestigious journals, such as Neurosurgery, Stroke, American Journal of Neuroradiology. Dr. Rafael Rodríguez Mercado possesses a Doctorate in Medicine at the School of Medicine of the University of Puerto Rico, he was appointed Associate Professor in Surgery of Uniformed Services University of Health Sciences of the Armed Forces of the United States.

RAFAEL

With this appointment, he joined the faculty of this prestigious military university. He was attending physician as neurosurgeon at Walter Reed Medical Hospital and Brook Army Medical Center.

In 2010, he was chosen unanimously, as Chancellor of the Medical Sciences Campus of the University of Puerto Rico.

He was appointed by Governor Ricardo Rossello Nevares as Secretary of Health of PR until March 2020 when he returned to his academic career. Dr. Rafael Rodríguez Mercado is married to Wanda SantiagoPimentel, a Medical Technologist, and is the proud father of a young university student, Rafael Alejandro.

RODRIGUEZ-MERCADO MD, FAANS, FACS !

LINDA RESTREPO Linda Restrepo is Director of Education and Innovation Human Health Education and Research Foundation. She has been a recognized Women in Technology Leader Cybersecurity and Artificial Intelligence.

Restrepo's expertise also includes Exponential Technologies Management, Computer Algorithms, Research, Implementation Management of Complex Humanmachine Systems. Interstellar exploration and Mars Human Habitats; Global Economic Impacts Research.

Restrepo is President of a global government and military defense multidisciplinary research and strategic development firm.

She has directed Corporate Technology Commercialization through the US National Laboratories. Emerging Infectious Diseases, Restrepo is also the Chief Executive Officer of Professional Global Outreach. Restrepo has advanced degrees from The University of Texas and New Mexico State University.

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LINDA RESTREPO PUBLISHER EDITOR

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TECHNOLOGY IN THE MAKING

INNER SANCTUM VECTOR N360™© LINDA RESTREPO

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PUBLISHER - EDITOR

TECHNOLOGY IN THE MAKING DISCLAIMER: This Magazine is designed to provide information, entertainment and motivation to our readers. It does not render any type of medical, political, cybersecurity, computer programming, defense strategy, ethical, legal or any other type of professional advice. It is not intended to, neither should it be construed as a comprehensive evaluation of any topic. The content of this Presentation is the sole expression and opinion of the authors. No warranties or guarantees are expressed or implied by the authors or the Editor. Neither the authors nor the Editor are liable for any physical, psychological, emotional, financial, or commercial damages, including, but not limited to, special, incidental, consequential or other damages. You are responsible for your own choices, actions, and results.

LINDA RESTREPO

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