With Contrast – and Clot Stroke

At last I have decided to explain how the arterial system works in the brain and why clots should be dissolved. Someone with medical experience some 30 years ago gave me some advice, which leaves plenty of space for errors.

Some 30 or 40 years ago (you can say that when you are 88) I saw the development of high pressure injectors for contrast media into the vascular system. I thought the pressure would rupture all blood vessels, but no, these injectors are in common use with catheters into arteries. I mention this as proof of pressure and speed generated in arterial blood by the heart pump. That settles one part of my layperson’s story of clot stroke. The other part is the porous walls the arteries have as they progress into the brain. So I propose that blood movement at speed past the porous walls is necessary to pass oxygen-rich blood cells onto the brain. That will suffice (I love that word) as a basic explanation. But the porous system must be described if we are to understand its ability to capture passing blood cells. There will be serrated protrusions of fibrous material into the blood system, diverting blood cells to the brain through the porous artery walls resulting in a deposit of blood cells on the brain[1]. Close to the entry of the arteries into the brain there will be a large diversion of blood cells because they serve a large portion of the brain. Also the blood supply will be depleted and slowed down. This is o.k., because areas further into the brain need less oxygen.

All of the above is a result of induction and guess work – take your pick.

So, without rushing blood there can be no oxygen transfer to the brain, and that’s what a clot does. However, it is not as simple as that, which explains why neurologists rush to dissolve clots.

I will explain the benefits of dissolving clots, and the disaster of leaving them alone.

A clot comes in three parts.

• The plaque, which is jammed against the artery wall preventing any blood transfer.
• The entry, where arterial blood comes to a halt at the clot and remains unable to transfer blood to the brain. The length of the entry extends to the nearest junction, effectively extending the effects of the clot to that point.
• The exit, where the clot clamps off the supply of power to the blood which becomes static and unable to transfer blood to the brain, effectively extending the effect of the stroke to the area deprived of arterial power.

So, if my exposition is correct, we can see that doing nothing can turn a middle level stroke into a major one. And a major level stroke into a life threatening disaster.

I am content that my reasoning is correct, and so do the neuros[2] (without knowing it). As the race with clot busting injectors to treatment rooms where appropriate patients await.

To disagree you must be able to say with a straight face “Blood clots do no harm”

That’s all for now.

Angus

P.S. Would you believe that someone in the stroke industry wrote that it should aim for 20% clot busting treatments! I’m speechless. No I’m not, try 100%.

Angus

[1] “What is a stroke” N.S.F. publication, “When blood stops flowing the brain does not receive the oxygen it needs there are brain cells in the area die.”

My explanation goes further by explaining the mechanism of transfer.

[2] Seen in a S.B.S Doco!