MRI may predict stroke onset
Washington: Some patients who suffer an acute ischemic stroke - in which a blood clot or other obstruction blocks blood flow in the brain - can be treated with a drug called tissue plasminogen activator, or tPA, that dissolves the clot and restores blood flow.
However, the clot-busting drug can only be administered within four and a half hours of the onset of a stroke; when given beyond that window of time, the drug can cause bleeding in the brain.
"As many as a quarter of all stroke patients cannot be given tPA because they wake up with stroke symptoms or are unable to tell their doctor when their stroke began," said lead researcher Catherine Oppenheim of the Universite Paris Descartes in France.
In the study, Oppenheim and her team reviewed data from consecutive patients with acute ischemic stroke treated at Sainte-Anne Hospital in Paris between May 2006 and October 2008.
The time of stroke onset was well defined in all patients and each underwent MRI within 12 hours.
The 130 patients in the study included 77 men and 53 women (mean age 64.7).
Of those, 63 patients underwent MRI within three hours of stroke onset and 67 were imaged between three and 12 hours after stroke onset.
Using the MRI data alone, the radiologists were able to predict with greater than 90 per cent accuracy which patients had experienced stroke symptoms for longer than three hours.
"When the time of stroke onset is unknown, MRI could help identify patients who are highly likely to be within the three-hour time window when tPA is proven effective and approved for use," said Oppenheim.
According to Oppenheim, using MRI to determine the duration of a stroke would change the way stroke is managed in the emergency setting.
"With the use of MRI, all stroke patients could be managed urgently, not just those patients with a known onset of symptoms," she said.
The findings were published in the journal Radiology .