Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New research pinpoints best treatment for stroke

20.04.2005


Results suggest CT perfusion improves outcomes



Interventional neuroradiologists at West Virginia University School of Medicine and Hospitals today presented the largest study to date on the utility of computed tomography (CT) perfusion imaging of the brain in determining and predicting stroke outcomes. Results will help better identify patients who are suitable candidates for treatment utilizing either clot busting medicines or clot retrieval devices. The research was presented to leading neurosurgeons at the 73rd annual meeting of the American Association of Neurological Surgeons.

The research, which examined 705 stroke patients, is significant because it allows doctors to customize stroke treatments based on the degree of brain death, instead of relying solely on how soon or late a patient comes to the hospital after having stroke symptoms. Stroke is the third leading cause of death among Americans. According to the American Stroke Association, 700,000 people each year experience a stroke. WVU researchers believe this research could change national protocols on how stroke patients are triaged and potentially extend treatment opportunity beyond the three-to-six hour window.


Under NIH stroke guidelines, hospitals typically administer tPA (a clot-busing drug) to patients within a three-hour window of stroke onset. After six hours, it’s generally considered too risky to administer even interarterial clot busting medicines, due to the risk of a potentially deadly hemorrhage.

But research presented by interventional neuroradiologists Jeff Carpenter, M.D., and Ansaar Rai, M.D., Assistant Professors at The Department of Neurological Surgery of West Virginia University School of Medicine, suggests more lives might be saved and debilitating side effects minimized if treatment of stroke patients was based on qualitative and quantitative imaging such as CT perfusion and CT angiography and not on generalized application of arbitrary time windows of three of six hours.

Those windows can exclude some patients who may benefit from treatment and include others who may suffer from serious complications of the treatment. Application of his research could increase the time window of treatment for stroke patients to greater than seven hours. This is significant because patients often don’t present to hospitals until after the three-hour window has closed because they don’t recognize the symptoms of stroke, can’t summons help quickly, or reside in rural areas. Additionally, those that do present in time can receive treatment that results in hemorrhage. A 2003 study published in Stroke which analyzed 15 published reports of tPA use in more than 2600 acute stroke patients found the intracerebral hemorrhage rate was 5.2 percent.

The WVU study shows that CT perfusion, which measures blood flow, is very accurate at determining which patients would best benefit from treatment and which should not receive clot-busting drugs. In the study, less than one percent of patients suffered a hemorrhage after receiving tPA, compared with the average of 5.2 percent of patients cited by the Stroke study.

CT perfusion allows radiologists to determine which portions of a stroke patient’s brain are dead, and which portions are dying but capable of being salvaged. Once a ratio of dead to dying brain is calculated, doctors can determine the best course of treatment. Only those patients whose brains are damaged but still alive will benefit from that treatment of acute revascularization of a blocked blood vessel.

To determine accuracy of CT perfusion, patients received both CT perfusion and an MRI. Results of the study presented shows that CT perfusion results correspond exceedingly well to MRI studies on several parameters including measuring cerebral blood volume, which indicates the severity of a blockage. About 60 percent of patients deemed candidates for intervention following CT perfusion were able to have their clots removed successfully by interarterial administration of tPA and the MERCI (corkscrew) procedure. In MERCI, the blood clot causing the stroke is removed by threading a corkscrew-like device through a catheter fed through the groin.

While MRIs are considered the gold standard for post stroke analysis, they are rarely performed and generally impractical because: they take 30 minutes to perform, require a stroke patient to be still to capture clean images (the patient may be moving or thrashing), require doctors to check for metal in the patients body (which may be impossible if no family members are present) and the MRI units themselves are often not adequately staffed or not located near the emergency room.

CT perfusion offers distinct advantages because most hospital emergency rooms use them frequently for other purposes, they take one to two minutes to scan (versus 30 minutes for MRI), and provide clear images even if a patient cannot lie perfectly still. Most hospitals need only to buy software (at a relatively inexpensive cost) to upgrade their systems and institute training programs.

In the coming months, Drs. Carpenter and Rai are expecting to publish their study in a nationally recognized journal.

Paul Moniz | EurekAlert!
Further information:
http://www.widmeyer.com

More articles from Studies and Analyses:

nachricht Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung

nachricht Scientists reveal source of human heartbeat in 3-D
07.08.2017 | University of Manchester

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

A Map of the Cell’s Power Station

18.08.2017 | Life Sciences

Engineering team images tiny quasicrystals as they form

18.08.2017 | Physics and Astronomy

Researchers printed graphene-like materials with inkjet

18.08.2017 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>