Stroke is the leading explanation for disability worldwide and the second leading explanation for death, but proper early intervention can prevent serious consequences. A recent study led by investigators at Brigham and Women’s Hospital, a founding member of the Mass General Brigham health system, and colleagues developed a recent test that mixes blood biomarkers with clinical assessment to discover patients who’ve had a big vessel occlusion (LVO) stroke. with high accuracy. Their results are published within the journal Stroke: vascular and interventional neurology.

Now we have developed a game-changing, accessible tool that will help be sure that more people affected by stroke are in the appropriate place at the appropriate time and receive critical, life-restoring care.”

Joshua Bernstock, MD, PhD, senior creator, clinical associate within the Department of Neurosurgery at Brigham and Women’s Hospital

Most strokes are ischemic, during which blood flow to the brain is obstructed. LVO strokes are an aggressive variety of ischemic stroke that happens when a significant artery within the brain is blocked. When blood flow to the brain is impaired, the shortage of oxygen and nutrients causes brain cells to die inside minutes. LVO strokes are a serious emergency and require rapid treatment with mechanical thrombectomy, a surgical operation that removes the blockage.

“Mechanical thrombectomy has made it possible to completely restore health to individuals who would otherwise have died or develop into significantly disabled as if the stroke had never happened,” Bernstock said. “The sooner this intervention is implemented, the higher the patient’s end result. This exciting recent technology has the potential to enable more people around the globe to profit from this treatment more quickly.”

The research team previously checked out two specific proteins present in capillary blood, one called glial fibrillary acidic protein (GFAP), which can be related to brain bleeding and traumatic brain injury, and the opposite called D-dimer. On this study, they showed that levels of those blood biomarkers combined with the Field Assessment of Stroke by Emergency Destination (FAST-ED) rating can discover LVO ischemic strokes while ruling out other conditions corresponding to bleeding within the brain. Brain bleeds cause symptoms much like those of an LVO stroke, making them difficult to differentiate from one another in the sphere, however the treatment for every is totally different.

On this prospective, observational study of diagnostic accuracy, researchers analyzed data from a cohort of 323 patients coded for stroke in Florida between May 2021 and August 2022. They found that combining GFAP and D-dimer biomarker levels with FAST-ED data collected lower than six hours after symptom onset allowed the test to detect LVO strokes with 93 percent specificity and 81 percent sensitivity. Other findings included the indisputable fact that the test excluded all patients with brain bleeds, signaling that the technology could eventually be used to detect intracerebral hemorrhage in the sphere as well.

Bernstock’s team also sees promising potential future use of this available diagnostic tool in low- and middle-income countries where advanced imaging isn’t all the time available. It may be useful within the evaluation of patients with brain injuries. They then conduct one other prospective trial to measure the effectiveness of the test utilized in the ambulance. In addition they developed an intervention study that uses this technology to hurry triage of stroke patients by bypassing standard imaging tests and moving on to the intervention.

“In stroke treatment, time is brain,” Bernstock said. “The earlier a patient is placed on the appropriate treatment path, the higher he’ll do. Whether meaning ruling out bleeding or deciding whether an intervention is required, with the ability to try this within the pre-hospital setting with the technology we have now built will probably be truly transformative.”