New test cuts stroke di­ag­no­sis time

The Star Early Edition - - HEALTH -

A NEW fin­ger-prick test could be a life­saver for stroke pa­tients as it cuts di­ag­no­sis time to un­der five min­utes.

By avoid­ing the need for time-con­sum­ing scans, it means treat­ment to re­duce per­ma­nent brain dam­age can be­gin ear­lier, ie, in the am­bu­lance be­fore the pa­tient ar­rives at hospi­tal.

The de­vice, which is sim­i­lar to those used by peo­ple with di­a­betes, is be­ing tri­alled on 375 Na­tional Health Ser­vice pa­tients and could be ap­proved for use in hos­pi­tals by early next year.

The blood test, SmartChip, checks com­pounds called purines which are pro­duced by cells when de­prived of oxy­gen as oc­curs in is­chaemic stroke, where clots stop the blood sup­ply.

Roughly 85% of strokes are is­chaemic stroke: the re­main­der are haem­or­rhagic, caused by bleeds in the brain as a re­sult of a burst blood ves­sel.

Dur­ing the ini­tial stage of a stroke, ap­prox­i­mately two mil­lion brain cells die ev­ery minute, so the faster the oxy­gen sup­ply can be re­stored, the more of the brain can be saved.

One of the chal­lenges for doc­tors and paramedics is de­ter­min­ing the type of stroke and di­ag­nos­ing it, based on symp­toms which over­lap with other con­di­tions such as seizures or brain tu­mours.

Paramedics look for signs such as fa­cial droop­ing, arm weak­ness and speech dif­fi­cul­ties but some­times other con­di­tions can be mis­taken for strokes, or real strokes may be missed.

Is­chaemic stroke is treated with clot-bust­ing drugs. If given in 30 min­utes, the chance of full re­cov­ery can be as high as 90%. But this falls to around 50% three hours later.

Haem­or­rhagic strokes are treated with drugs that al­low the blood to clot, so it’s crit­i­cal the type is de­ter­mined quickly to al­low ef­fec­tive treat­ment. This in­volves a CT or MRI scan in hospi­tal, which can take hours, los­ing pre­cious time.

If a stroke is sus­pected, a fin­ger-prick drop of blood from the pa­tient is added to a dis­pos­able strip.

This is in­serted into a hand-held reader which displays purine lev­els within three to five min­utes.

Early re­sults from the trial show much higher lev­els in is­chaemic stroke pa­tients com­pared to healthy peo­ple. They also show that the higher the level, the greater the amount of brain tis­sue af­fected by the stroke. These re­sults can be used to guide treat­ment.

“The use of rapid blood tests to iden­tify pa­tients with stroke is a very im­por­tant and ex­cit­ing area of re­search, and the re­sults of this trial are awaited with keen in­ter­est,” Dr Richard Perry, a con­sul­tant neu­rol­o­gist at Univer­sity Col­lege Lon­don Hos­pi­tals, said.

“Purine re­leased into blood seems a good po­ten­tial can­di­date for iden­ti­fy­ing an acute brain in­jury, but it’s un­clear if it can dis­tin­guish be­tween block­age and rup­ture of an artery as a cause.

“These two types of strokes re­quire very dif­fer­ent treat­ment strate­gies, so dis­tin­guish­ing them early is an­other im­por­tant goal for blood biomarker stud­ies.”

Mean­while, be­ing over­weight or even mildly obese could boost your chances of sur­viv­ing a stroke, re­searchers at Bos­ton Univer­sity School of Medicine said.

They mon­i­tored al­most 800 peo­ple for 10 years af­ter a stroke and found those who were over­weight or mildly obese (with a BMI of 25 or more) had bet­ter sur­vival com­pared to those of nor­mal weight. – Daily Mail


TELL-TALE SIGN: A fin­ger-prick drop of blood is added to a dis­pos­able strip and in­serted into a hand-held reader which displays purine lev­els.

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