News

One of the ongoing debates in the medical community has centred around the best type of anaesthesia to use during mechanical thrombectomy, the gold-standard procedure for removing large blood clots from brain vessels. A new, robust multicentre trial led by researchers at UTHealth Houston has provided compelling evidence that finally offers some clarity and direction.

The trial, involving a significant cohort of 260 patients, directly compared two approaches: general anaesthesia and moderate sedation. Prior studies on this topic have been a mixed bag, with some even suggesting that moderate sedation might be superior, while others found no difference. The lack of consensus meant variations in practice across hospitals, but this new trial provides a clearer path forward.

The results were remarkable and strongly in favour of general anaesthesia. The study found that patients who were placed in a fully induced state of general anaesthesia during their mechanical thrombectomy procedure had better neurological function outcomes at the three-month mark compared to those who received only moderate sedation. This improvement in function is a crucial measure of recovery and quality of life for survivors.

The reasons for this improved outcome are likely multi-faceted. One theory is that general anaesthesia provides a more stable and controlled environment for the surgeon. It can help prevent patient movement, ensure stable blood pressure, and potentially allow the surgical team to perform the delicate clot retrieval more quickly and efficiently. In a procedure where speed is paramount, any factor that reduces procedural time can directly translate into saved brain tissue and improved patient outcomes.

This study is a significant step towards optimising stroke treatment protocols. The findings suggest that general anaesthesia should be a serious consideration for future standard practice during these life-saving procedures. For the stroke survivor community and their families, this research offers hope that ongoing advancements in medical science are continually refining the care we receive, helping to ensure the best possible chances for a strong recovery and life beyond stroke. It underscores the importance of rigorous research in driving forward better patient outcomes.

People who have survived a stroke face a significantly elevated risk of recurrence, which often leads to cumulative neurological damage and a progressive decline in cognitive function. This cognitive impairment can be as debilitating as the physical symptoms, severely impacting quality of life.

In a proactive effort to address this critical medical challenge, Royal United Hospitals Bath (RUH Bath) is currently recruiting participants for a vital clinical trial: the LACunar Intervention Trial-3 (LACI-3). There will be at least 60 more hospitals in the UK where this trial will be carried out and the recruitment aim is 1,300 patients.

This study is exploring whether two existing medications – isosorbide mononitrate and cilosta*zol – could help prevent further strokes and improve cognitive function in patients who’ve experienced a lacunar ischaemic stroke. This type of stroke affects around 35,000 people each year in the UK, leading to problems with cognitive function and can sometimes lead to dementia.

Repurposing existing drugs for new indications can significantly accelerate the path to patient benefit, as their safety profiles are already well-understood. This trial aims to rigorously test whether these medications can provide the crucial added layer of protection needed by high-risk patients. While current guidelines focus on blood pressure control and lifestyle modifications, there remains an unmet need for pharmacological interventions that specifically target the mechanisms leading to both stroke recurrence and vascular cognitive impairment.

RUH Bath is looking for volunteers aged 30+ who’ve had a lacunar stroke and participation lasts around 18 months, with most follow-ups done by phone. Survivors who meet the study’s criteria are encouraged to contact the research team for further details on how to get involved in this potentially transformative research. To find out more, contact the stroke research team on 01225 824120 : laci-3@ed.ac.uk or ruh-tr.strokeresearch@nhs.net

This study is led by the University of Edinburgh and University of Nottingham, and is funded by NIHR. Principal investigator: Professor Joanna Wardlaw: joanna.wardlaw@ed.ac.uk

There’s incredibly exciting news from the medical world that offers a massive ray of hope for stroke survivors. During the recent 17th World Stroke Congress in Barcelona, Lumosa Therapeutics announced highly promising, positive results from their Phase 2b clinical trials for a new drug called LT3001. This groundbreaking medication is showing immense potential to change the game entirely by extending the crucial therapeutic window for ischemic stroke from the current 4.5 hours to a remarkable 24 hours.

The race against the clock after a stroke often means that far too many stroke patients arrive at the hospital too late for effective treatment; but the data for LT3001 suggests a safer alternative is on the way. Trials have shown that the drug maintained a favourable safety profile with no significant increased risk of bleeding, a major concern with existing treatments like tPA. And, more importantly, patients treated with LT3001 within this hugely extended window showed clear signals of improved functional outcomes, particularly for those with moderate-to-disabling strokes.

What happens next? Well, these positive Phase 2b results are the springboard for the next big leap; global Phase 3 trials. While this is a pivotal step, it means LT3001 is still a few years away from becoming a routine treatment. The process involves conducting large-scale Phase 3 trials, submitting data to regulatory bodies like the MHRA in the UK and awaiting final approval.

A realistic and optimistic estimate for LT3001’s widespread availability in routine UK clinical practice might be somewhere in the early 2030s… around 5 to 8 years from now… assuming all future trials are successful and regulatory hurdles are cleared efficiently.

Virtual reality (VR) and augmented reality (AR) technologies hold incredible potential, not just for entertainment, but also for innovative rehabilitation methods. We’ve seen promising results where VR aids motor recovery by providing engaging, motivating environments for practice.

However, a new study from the University of Bath has issued a crucial warning: the next generation of hand gesture controls being developed for these systems risks excluding millions of people, including many in our stroke survivor community. This is a critical issue that stroke professionals and survivors need to be aware of.

The research highlights that the freehand controls becoming standard in new systems; gestures like pinching, swiping and pressing virtual buttons…are often inaccessible, painful or simply too fatiguing for individuals with even mild upper limb impairments. For a stroke survivor, who may deal with reduced manual dexterity, spasticity or weakness, these design choices can be a major barrier to using technology that could otherwise be a powerful tool for recovery and daily life engagement.

A key finding from the study points to the ubiquitous ‘pinch to select’ gesture. This action relies heavily on the index finger, a joint often significantly affected by conditions like stroke. Current VR systems rarely offer alternative, more adaptable gestures, effectively locking out users who cannot perform this specific, rigid movement. Furthermore, the study noted that tech companies are increasingly favouring smaller, faster gestures in pursuit of efficiency… a trend that exacerbates accessibility issues for those with motor control challenges.

For healthcare professionals, this is a call to action. When considering VR for patient use, we must evaluate not just the therapeutic potential but also the physical accessibility of the interface. The current ‘one-size-fits-all’ approach to hand gestures is inadequate. The Bath researchers are advocating for accessibility to be a fundamental part of the design process from the very beginning, not just an afterthought or a ‘nice to have’ feature.

Potential solutions suggested by the study include simple but impactful changes: allowing users to fully remap gestures to movements that are comfortable for them, enabling the amplification of small, controlled movements and offering software-based stabilisation for users with tremors. Such adaptive features would ensure that the benefits of this exciting technology are available to all, regardless of their physical capabilities.

The announcement from the Royal Preston Hospital that it will begin offering 24/7 thrombectomy services by February 1st, 2026, is a major milestone for stroke care in Lancashire and South Cumbria.

This initiative addresses a critical issue that has long plagued stroke treatment; the disparity in care between in-hours and out-of-hours presentations. For patients with severe ischemic strokes caused by a large vessel occlusion, a mechanical thrombectomy is a game-changing intervention that can dramatically improve functional outcomes and reduce long-term disability. Its effectiveness, however, is highly time-dependent, making round-the-clock availability not just desirable but essential.

The situation at Royal Preston highlights a systemic challenge. While some UK hospitals have offered 24/7 thrombectomy for years… St George’s in London was an early pioneer, with others like Barts Health and University Hospital of North Midlands (UHNM) following suit… many still operate with limited hours.

A 2022 Stroke Association report indicated that only a minority of thrombectomy centres were offering 24/7 cover, with many still operating on a limited-hours basis. This has led to a persistent postcode lottery of care, where a patient’s chance of a good recovery is tied to their location and the time of day their stroke occurs. Nottingham’s Queen’s Medical Centre also recently transitioned to a 24/7 service in October 2025, further adding to the growing number of centres providing continuous care. However, to achieve full national coverage, the UK needs to overcome significant hurdles, primarily chronic underfunding and a shortage of specialised interventional neuroradiologists.

Given the historical pace of implementation and the current workforce limitations, making a precise prediction about when the entire UK will achieve 24/7 thrombectomy coverage is hard to do; despite ambitions set by national bodies, past targets have been missed. A realistic, though optimistic, forecast suggests that it could be another five to ten years before all eligible patients across the UK have consistent, 24/7 access to thrombectomy.

Full coverage will require a concerted and well-funded national effort to increase the number of trained specialists, improve hospital infrastructure, and ensure efficient patient transfer pathways.Some countries with well-integrated neuroscience centres, such as Germany, Holland, Canada and parts of the US have achieved significantly higher thrombectomy access rates and broader 24/7 coverage than the UK, demonstrating that this goal is achievable with sustained investment and strategic planning.

Foot drop, a common consequence of stroke and other neurological conditions, presents a significant mobility challenge for so many survivors, including me. Traditional management often relies on ankle-foot orthoses (AFOs) and/or compensatory walking strategies, which can be restrictive or increase metabolic cost during ambulation. The development of adaptive footwear, such as the Cadense shoe, represents an innovative approach to mitigating the functional deficits associated with foot drop: via hrough its patented Variable Friction Technology, Cadense aims to reduce tripping hazards and facilitate a smoother, more efficient gait pattern for individuals with neuromuscular weakness.

The core of the Cadense technology lies in its unique outsole design. The sole features two elevated nylon pucks on either side of the shoe’s forefoot, creating a low-friction surface that facilitates a gliding motion during the swing phase of the gait cycle. This allows the foot to slide over obstacles and uneven surfaces more easily, addressing the primary cause of tripping in individuals with foot drop. As the foot comes into contact with the ground during the stance phase, pressure on the shoe activates a recessed, high-friction rubber section of the sole, which provides a stable platform for stopping and toe-off, ensuring users maintain control and confidence throughout the walking process.

For stroke survivors, user testimonials and early reports suggest a positive reception. Reviewers frequently praise the shoe’s ability to reduce their fear of tripping and falling, leading to increased confidence and independence. Many users note that the shoe’s design, which includes an easy-on, easy-off Velcro closure disguised as laces, simplifies their daily routines. The aesthetic is also frequently mentioned, with users appreciating that the shoe looks like fashionable, regular trainers rather than overt medical or orthopaedic footwear. For some, the use of the Cadense shoe has even enabled them to decrease their reliance on or forgo an AFO altogether, although it is important to note this varies based on the individual’s specific needs and the severity of their foot drop.

Early research, including an NIH-funded study at the Shirley Ryan Ability Lab, is investigating the clinical impact of this variable friction technology on gait mechanics and training outcomes.

Cadense adaptive footwear is indeed available for purchase in the UK. The shoes can be bought directly from the Cadense UK website, Cadense.co.uk. The price for a pair of the adaptive trainers is approximately £199.99. Shoppers are often offered free delivery and a 30-day risk-free trial period, allowing users to test the shoes’ effectiveness before committing to the purchase. The availability of different styles and sizes, including wide-fit options, further enhances accessibility for individuals with diverse needs.

While the Cadense shoe offers a promising, non-invasive intervention for foot drop, survivors considering this or any adaptive footwear should consult with a ARNI instructor or other physio to ensure it is appropriate for their specific rehabilitation goals and walking impairments.

A 2025 scoping review titled ‘Stroke at the Hairdresser’s Chair’, which was published in the American Journal of Emergency Medicine, synthesised data from 22 previous studies over five decades to provide a comprehensive look at Beauty Parlor Stroke Syndrome (BPSS), a rare but clinically significant phenomenon.

The review analysed 54 reported cases, finding that a significant majority (79.63%) were women, with occurrences linked to neck hyperextension during salon visits, dental procedures, and other activities. Researchers highlighted that while BPSS is uncommon, its symptoms can overlap with those of a classic stroke, emphasising the importance of thorough patient history and neuroimaging for an accurate and timely diagnosis. The study concluded that preventative strategies, such as providing neck support in salons and raising awareness among both clients and professionals, are essential for mitigating this risk. 

The term ‘Beauty Parlor Stroke Syndrome’, while it may seem colloquial, points to a clinically significant phenomenon: vertebral artery dissection or compression caused by sustained hyperextension of the neck. The setting of a salon shampoo bowl is the most commonly cited trigger, where a patient’s head is tilted backward over a basin’s edge for an extended period, creating mechanical stress on the vessels supplying the brain’s posterior circulation. First described by Dr. Michael Weintraub in 1993, the syndrome highlights how seemingly innocuous, everyday activities can precipitate serious neurological injury, particularly in susceptible individuals.

The underlying pathophysiology centres on compromise of the vertebral arteries, which ascend through the cervical spine to join and form the basilar artery. This critical system supplies blood to the brainstem, cerebellum, and posterior cerebrum. When the neck is hyperextended, especially against a hard surface, this can cause a vessel wall to dissect; a tear that can lead to intramural hematoma formation, luminal occlusion or the release of a clot that embolises to the brain. In other cases, external compression from osteophytes or soft tissues can temporarily restrict blood flow, a phenomenon known as vertebrobasilar insufficiency. The resulting posterior circulation strokes can manifest with symptoms such as dizziness, vertigo, ataxia, visual disturbances, and slurred speech, with symptom onset often delayed for hours or even days.

Epidemiological data, predominantly from case reports and small case series, indicates that while the syndrome is rare, it is disproportionately reported in women. For example, a recent scoping review identified that 79.63% of the 54 cases reviewed were female, with a wide age range from teenagers to the elderly. These findings are critical, as they underscore the need for awareness among patients and salon professionals alike. Risk factors for cervical artery dissection extend beyond the salon, encompassing other activities involving neck hyperextension, such as yoga, painting ceilings, or sudden movements like sneezing. Individuals with pre-existing vascular conditions, such as atherosclerosis, fibromuscular dysplasia or connective tissue disorders, may be at a heightened risk, though the syndrome can also affect young, otherwise healthy individuals.

Raising awareness in the beauty and wellness industries is a crucial preventative measure. Salons can mitigate risk by providing proper neck support, such as rolled towels or cushions, and adjusting chairs to reduce the degree of cervical hyperextension. Patients should be encouraged to communicate any discomfort or neck pain immediately during a shampoo. While the overall risk remains low, the potential for devastating long-term disability; from permanent balance issues to severe neurological deficits… warrants increased vigilance. For clinicians, maintaining a high index of suspicion is essential, particularly when evaluating patients presenting with posterior circulation symptoms following recent neck manipulation. A comprehensive patient history that includes recent activities is vital for accurate and timely diagnosis through neuroimaging. Ultimately, the phenomenon of ‘Beauty Parlour Stroke Syndrome’ is not an urban legend but a clinically confirmed, though rare, condition that necessitates proactive awareness and preventative strategies.

The journey of regaining mobility after a stroke can be arduous, often characterised by the persistence of gait asymmetries and diminished walking endurance. Traditional robotic exoskeletons have offered a partial solution, providing mechanical assistance in structured rehabilitation settings.

However, the inherent variability in stroke-affected gait patterns presents a significant challenge, as many devices struggle to adapt effectively to the unique and often unpredictable movements of individual patients. This rigid approach can inadvertently impede natural joint movements and potentially lead to user discomfort and fatigue, undermining the therapeutic intent.

A groundbreaking development emerges from the George W. Woodruff School of Mechanical Engineering at Georgia Tech, where Associate Professor Aaron Young and his research team have pioneered an AI-powered exoskeleton designed to assist lower limb mobility for stroke survivors. Their innovation addresses the limitations of conventional exoskeletons by introducing a system that prioritises user adaptability and intuitive control. The core of this advancement lies in its AI-driven control architecture which is capable of learning and adapting to the user’s specific gait patterns in real-time.

The team’s research, just published in IEEE Transactions on Robotics, focuses on developing a neural network that functions akin to the human brain… processing sensory inputs from the exoskeleton to precisely modulate assistance for each step.

This intelligent system learns a patient’s unique gait within a remarkable timeframe of just one to two minutes, significantly reducing the laborious manual tuning traditionally required by engineers. The AI continuously monitors and adjusts its support, ensuring the exoskeleton remains synchronised even as the patient’s stride shifts or improves. This results in a 70% reduction in errors compared to standard exoskeletons in tracking stroke patients’ walking patterns, marking a substantial leap in precision and responsiveness.

Beyond the immediate benefits observed in the lab, such as reducing the metabolic cost of walking and improving gait efficiency, this technology holds broader implications. The same adaptive approach could prove invaluable for older adults experiencing age-related muscle weakness, individuals with conditions like Parkinson’s or osteoarthritis, and children with neurological disabilities.

Furthermore, the team has addressed the challenge of data interoperability across different exoskeleton systems by developing software that functions as a universal adapter, allowing the AI to integrate with various devices with minimal calibration. This eliminates the need for extensive retraining when switching between exoskeletons, further streamlining the rehabilitation process.

Clinical trials are now underway to rigorously evaluate the exoskeleton’s performance across a wide range of daily activities.

In the high-stakes world of acute stroke care, where every second counts, the speed and efficacy of intervention are paramount to saving brain cells and minimising long-term disability. A revolutionary breakthrough from Stanford University’s Department of Mechanical Engineering and Neuroimaging, published in Nature in June 2025, promises dramatic possibilities. Researchers, including Renee Shao and Jeremy Heit, have unveiled a novel spinning micro-device, the ‘milli-spinner,’ designed to remove brain clots with unprecedented precision and effectiveness.

Current thrombectomy procedures for large vessel occlusion (LVO) strokes, while effective, still have significant limitations. These methods often involve either aspiration catheters that can struggle with larger clots or stent retrievers that grapple and pull the clot, risking fragmentation and dispersal of pieces into smaller, more difficult-to-reach vessels. This can lead to incomplete recanalisation and further brain damage.

The milli-spinner, by contrast, operates on a fundamentally different and more elegant principle. As a tiny, catheter-delivered tool, it utilises a combination of localised suction, compression, and shear forces generated by its rapid spinning action to gently and efficiently process the clot.

The device works by first applying localised suction to secure the clot against the tip of the catheter. The subsequent rapid rotation then creates shear forces that cause the fibrous protein mesh of the clot (fibrin) to roll into a tight, compact ball, shrinking its volume significantly—by up to 95% in preclinical tests.

This ‘fibrin-balling’ action effectively expels the trapped red blood cells, which can then safely continue flowing, leaving behind a manageable, dense clot that is easily removed via suction. This innovative mechanism drastically reduces the risk of fragmentation and subsequent distal embolisation, which are common and serious complications of existing methods.

The results from preclinical studies using flow models and animal subjects were nothing short of remarkable. In tests on tough, fibrin-rich clots that are notoriously difficult to treat with existing devices, the milli-spinner achieved a 90% first-pass success rate in restoring blood flow, a significant leap from the 11% success rate of conventional tools for these cases.

Overall, the device more than doubled the efficacy of current technology, suggesting a major paradigm shift in interventional neurosurgery. Jeremy Heit, Chief of Neuroimaging and Neurointervention at Stanford, called the milli-spinner ‘a sea-change technology,’ projecting that it could save tens of thousands of lives and substantially reduce disability if translated successfully to clinical practice.

The potential impact of this technology extends beyond just higher survival rates. The minimally invasive and highly precise nature of the milli-spinner suggests it could also lead to better functional outcomes and a reduced risk of long-term disability, a critical factor for stroke patients and their families. By achieving faster and more complete clot removal, the device maximises the salvageable brain tissue, a key determinant of post-stroke recovery.

While the device is still undergoing further development and requires clinical trials for human use, a company has already been launched to license the technology from Stanford and accelerate its path to market. The milli-spinner represents a brilliant fusion of engineering innovation and neurovascular medicine, offering renewed hope for a faster, safer and more effective future for stroke intervention.