• Posted February 8, 2024

Head Position May Be Key to Better Clot Removal After Stroke

The position in bed of stroke victims' heads could influence how well they'll fare in upcoming surgery to remove a blood clot from their brain, a new study finds.

Hospital beds for stroke patients are typically set up to keep the head elevated, researchers said.

But a flat head position prior to blood clot removal might lead to better outcomes, the results showed.

Patients displayed fewer immediate signs of brain damage if their heads were kept flat on the bed versus a 30-degree angle, according to findings presented at the American Stroke Association's annual meeting in Phoenix.

The results were so effective that a safety monitoring board called an early halt to the clinical trial, the researchers said.

“By three months following surgery, there was no difference in outcomes for patients in either group. However, it's exciting to see that we were able to discharge patients from the hospital with less disability requiring rehabilitation,” said lead researcher Anne Alexandrov, a professor of nursing and neurology at the University of Tennessee Health Science Center in Memphis.

Prior studies have shown that stroke patients awaiting brain clot removal benefited from better blood flow to the brain when their head was kept flat, researcher said.

“Optimizing blood flow to the brain while patients are waiting for surgery is essential to minimize the risk of neurological deficits and ultimately disability,” Alexandrov said in a stroke association news release.

For the study, researchers recruited 92 patients from 12 stroke centers in the United States, and randomly assigned them to either a flat or elevated head position in bed while they awaited surgery.

Prior to surgery, patients lying flat had greater stability and even improvement in their condition compared to those whose heads were elevated, results show.

Researchers also explored whether stroke patients kept flat would have any additional benefit following surgery. They didn't expect to find a difference because the surgery itself is so effective in improving patients' outcomes.

But at both 24 hours following surgery and at seven days after, those patients whose heads were not kept elevated displayed fewer neurological deficits than those whose heads were elevated.

Alexandrov noted that flat head positioning should not be considered a treatment for stroke, but a way to preserve brain function prior to surgery.

“It is a rescue maneuver, not a treatment,” Alexandrov explained.

Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

More information

NYU Langone Health has more about clot removal for stroke.

SOURCE: American Stroke Association, news release, Feb. 7, 2024