Level head position best for stroke patients

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When someone has suffered a Stroke, laying him or her flat seems best, a new study indicates.

According to a report in the medical journal Neurology, placing the head level with the body, instead of elevated 30 degrees as is typically done, improves blood flow to the brain in stroke patients.

The 30 degree position has been advocated as a way to reduce pressure inside the skull and, thereby, increase blood flow to the brain. However, there have been conflicting reports regarding the head position that achieves the best blood flow.

In the present study, Dr. Anne W. Wojner-Alexander and colleagues, from the University of Texas at Houston, used a special type of ultrasound to assess the effect of various head elevations on brain blood flow in 20 patients with a recent stroke.

Lowering the head-of-the-bed from 30 to 15 degrees and then to 0 degrees increased blood flow in all patients, the investigators report. On average, a 20 percent increase in flow was observed with most of this occurring in the drop from 30 to 15 degrees.

Changes in head elevation did not affect the blood pressure or heart rate, the researchers point out.

Three patients showed an immediate improvement in neurologic function after lowering of the head position, the authors note.

The results suggest that stroke patients may benefit from lower head positions than is typically used, the investigators conclude.

SOURCE: Neurology, April 26, 2005.

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