Cerebrovascular Accident Clinical Trial
Official title:
Inflammatory Biomarkers as Additional Tool to Neuroimaging in the Diagnosis and Management of Patients With Ischemic Stroke
Stroke represents the third commonest cause of death after heart disease and all types of
cancer combined, and is the leading cause of long-term permanent disability among adults.
Recombinant tissue plasminogen activator (tPA) is currently the only safe medical treatment
for acute ischemic stroke but only a small fraction of patients are eligible for a
thrombolysis treatment. Current guidelines on thrombolysis post stroke with tPA exclude its
uses beyond 3 hours after stroke onset and when time of onset is unknown thus excluding many
patients from potentially beneficial treatment.
For an appropriate triage and management of patients, it is essential to improve imaging
techniques beyond a simple CT scan. Perfusion computed tomography (PCT), currently
considered as an investigational technique, permits a quantitative determination of the
cerebral perfusion within the brain. It helps distinguish salvageable ischemic penumbra from
irreversibly infarcted core in acute stroke patients. This technique has therefore the
potential to select patients who are most likely to benefit from thrombolysis with tPA, can
be used to predict the benefit after thrombolysis and determine the suitability for other
therapeutic interventions. In patients with a primary diagnosis of TIA, PCT would help to
identify possible persistent cerebral ischemia but also provide important information for
rapid instigation of prophylactic strategies.
The diagnosis and management of patients with ischemic stroke and TIA is challenging and is
primarily based on clinical assessment in conjunction with neuroimaging. Development of
specific molecular biomarkers as additional tools to support a clinical diagnosis, exclude
common stroke mimics such as migraine or epileptic seizures, identify patients at risk of
disease, and help guide patient treatment by predicting complications following t-PA
treatment would be of great value.
n/a
Observational Model: Cohort, Time Perspective: Prospective
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