Deans' stroke musings: Blood Biomarkers to Differentiate Ischemic and Hemorrhagic Strokes Might Allow Prehospital Thrombolysis

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, March 7, 2021

Blood Biomarkers to Differentiate Ischemic and Hemorrhagic Strokes Might Allow Prehospital Thrombolysis

But is it faster and better than one of these? You don't even specify your timeframe. Time is Brain, you know.

Hats off to Helmet of Hope - stroke diagnosis in 30 seconds February 2017

Microwave Imaging for Brain Stroke Detection and Monitoring using High Performance Computing in 94 seconds March 2017

New Device Quickly Assesses Brain Bleeding in Head Injuries - 5-10 minutes April 2017

Ski-Mask Design AIR Coil Offers Whole-Brain Imaging Without Claustrophobia

The latest here:

Blood Biomarkers to Differentiate Ischemic and Hemorrhagic Strokes Might Allow Prehospital Thrombolysis

Alejandro Bustamante, Anna Penalba, Cyrille Orset, , View ORCID ProfileVíctor Llombart, Alba Simats, , Oriol Ventura, View ORCID ProfileMarc Ribó, Denis Vivien, Jean Charles Sanchez,

First published March 5, 2021, DOI: https://doi.org/10.1212/WNL.0000000000011742

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Abstract

Objective: We aimed to validate a panel of blood biomarkers to differentiate between ischemic stroke (IS) and intracerebral hemorrhage (ICH) in patients with suspected stroke.

Methods: Patients with suspected stroke admitted within 4.5 hours after onset were enrolled. Blood samples were collected at hospital admission. Glial fibrillary acid protein (GFAP), retinol binding protein 4 (RBP-4), N-terminal pro B-type natriuretic peptide (NT-proBNP) and endostatin were measured by immunoassays. Cut-off points were obtained for 100% specificity for IS. A high-sensitivity assay to measure GFAP and rapid point-of-care tests (POCTs) to measure RBP-4 and NT-proBNP were used in subsets of patients. Biomarker panels were evaluated in another cohort of 62 stroke mimics.

Results: A total of 189 patients (154 IS and 35 ICH) were enrolled. IS patients had higher RBP-4, NT-proBNP and endostatin and lower GFAP levels than ICH patients. The best biomarker combination for the identification of IS was RBP-4+NT-proBNP, which was able to identify 29.7% of IS patients with 100% specificity. In the subset of patients for whom GFAP was measured with the high-sensitivity assay, RBP-4, NT-proBNP and GFAP identified 51.5% of IS patients with 100% specificity. When stroke mimics were included, specificities were reduced to 98.4 and 96.8%, respectively. POCTs of RBP-4 and NT-proBNP showed results similar results to those of conventional ELISAs.

Conclusions: A biomarker panel including RBP-4, NT-proBNP and GFAP provided moderate but potentially useful sensitivity rates at 100% specificity for IS diagnosis. If confirmed in future studies, this strategy might allow pre-hospital treatment in selected patients.

Classification of Evidence: This study provides Class I evidence that a biomarker panel including RBP-4, NT-proBNP and GFAP distinguishes IS from ICH with moderate accuracy.