A Safe Way to Treat Unwitnessed Strokes

Orange County, CA - April 26th, 2018 -  

Researchers at the Massachusetts General Hospital (MGH) may be able to expand the number of stroke patients that can safely be treated with tissue plasminogen activator (tPA). tPA was approved by the Food and Drug Administration in 1996. It is a potent blood thinner that’s able to restore blood flow to the brain and limit any possible damage from a stroke.

Unfortunately, only 4 percent of stroke patients receive the medication. In order for it to work, the patient must receive the medication within the first few hours of symptoms. The window for this treatment can be up to 24 hours for some patients, however, the earlier they receive it, the better. TPA is not approved to use on patients whose symptoms aren’t visible and it prevents them from receiving the medication.

According to the press release, “U.S. Study eligibility was determined by a mismatch between two types of MR imaging studies – FLAIR, which typically only shows stroke effects on brain tissue after several hours of reduced blood flow, and diffusion-weighted imaging (DWI), a technique first applied to stroke patients at the MGH-based Athinoula A. Martinos Center for Biomedical Imaging that is extremely sensitive to changes beginning in the first minutes or hours after stroke onset.”

Abnormal brain tissue that shows up on the DWI, but not FLAIR has shown patients that were four hours or less after their first experience of any symptoms. Co-lead author Ona Wu, PhD of the Martinos Center states “That discrepancy provides a snapshot of tissue evolution as the stroke progresses in the first few hours, and that is the pattern we used to select patients for treatment, since they were likely to be similar to patients with known symptom onset who have benefited from tPA. Essentially we used an MR Witness – the name of the trial – to identify patients who might be treated with tPA because their strokes had not progressed to the point of irreversible injury.”