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Saturday, 12 February, 2000, 02:12 GMT
Stroke breakthrough could minimise damage

Brain scanner Brain scans can help assess damage

A new way of monitoring brain damage could significantly increase the number of stroke patients identified in time to receive vital treatment, say scientists.

However, poor facilities in the UK may mean that patients will not be able to take advantage of the advance.

Researchers at Johns Hopkins University in Baltimore say a series of simple tests of brain function combined with a type of MRI scan can single out stroke patients likely to benefit from treatment to restore blood flow to the brain.

The method looks as though it will let us identify patients who still have salvageable brain tissue, in whom we might be able to recover brain function
Dr Argye Hillis, Johns Hopkins University
Speaking at a meeting of the American Stroke Association on Friday, Dr Argye Hillis said: "The method looks as though it will let us identify patients who still have salvageable brain tissue, in whom we might be able to recover brain function."

Until now, neurologists have had no easy way to assess whether stroke patients' brain tissue can be salvaged.

As a result, only about 1% of stroke patients who get to hospital can be given drugs to break down blood clots in their brain.

Limited treatment period

To be both safe and effective, the clot-breaking drugs must be given during a "treatment window" within three hours of the start of a stroke, when actual brain tissue death is at its lowest point.

Patients unlikely to benefit from the clot-breaking drugs have large areas of dead tissue.

The proportion of potentially salvageable "distressed" tissue to dead tissue is the crucial factor in deciding whether to try to restore blood flow.

Dr Hillis said: "In some patients the amount of brain that's died is tiny, but they still have huge problems, for example, in comprehension or speech.

"Those are the ones who may be helped, and they don't always fall right within the three-hour limit."

Dr Hillis's team subjected 40 stroke patients to a series of simple tests, such as naming objects and reading words, within 12 hours of the onset of their symptoms.

The team compared results of the tests with brain images taken using two types of MRI scan, one revealing distressed tissue and the other dead tissue.

They found that by combining the tests and the scans it was possible to get a picture of how much tissue was dead and how much was probably salvageable.

Dr Hillis said: "We believe the two together could help plan therapy quickly."

She said the tests could also help monitor treatment, as the patients showed a marked improvement after blood flow to their brain was therapeutically restored.

UK lagging behind

The Stroke Association said the study had "interesting potential" for the 100,000 people in the UK who suffer a first stroke each year.

However, a spokesman said the clot-breaking medication mentioned in the study was not on general release in the UK.

In addition, access to MRI scans in the UK is poor. A recent survey found only 8% of consultants said they had unrestricted access to scans, and only 10% were able to scan stroke patients within 48 hours.

Stroke Association director Eoin Redahan said: "With the potential introduction of medications to attack blood clots the NHS needs to focus more on stroke and improving their reactions when someone has a stroke, including improved access to MRI scans."

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See also:
12 Oct 99 |  Health
Stroke care 'disorganised and haphazard'
14 Apr 99 |  Health
Stroke care in crisis
11 Feb 00 |  Health
Laser treatment for stroke
10 Nov 99 |  Health
Robot offers hope to stroke patients
08 Dec 99 |  Health
Artificial nerves aid stroke patients

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