A new MRI technique promises to help physicians determine the extent of damage to the blood-brain barrier in stroke victims, leading to safer, more individualized treatments for those patients.
The blood-brain barrier is the seal between the brain and capillaries and protects the brain from infection and inflammation. In an article published in the journal PLOS ONE, researchers say they have developed a new software tool that, used in conjunction with MRI scans, will help physicians avoid using clot-busting pharmaceuticals in patients who could suffer brain damage from those drugs.
According to lead researcher Richard Leigh, M.D., of the department of neurology at the Johns Hopkins University School of Medicine, when patients come to an emergency room three to four hours after suffering an ischemic stroke, doctors will treat them with an intravenous drug--tPA--to dissolve the clot that's caused the stroke. In about 6 percent of cases, however, the damage to the blood-brain barrier is already too severe and the treatment will cause bleeding in the brain, and possible death.
And most stroke patients, Leigh said in an article in Futurity, don't get to the hospital in time for optimal tPA treatment. In those cases, physicians won't give them the tPA for fear of causing a brain hemorrhage, meaning more aggressive treatment may be needed. An MRI will be given to determine the risks and benefits of more aggressive approaches, such as directly injecting tPA into the brain.
However, according to Leigh, traditional MRI doesn't reliably help physicians determine the subtle amount of damage to the blood-brain barrier that allows them to evaluate how well patients will respond to different treatments. Through more precise calculations from the new software tool, physicians are better able to define areas--and the extent--of blood-brain damage on MRI scans.
"It's a personalization of medicine," Leigh said, according to Futurity. "Rather than lumping everyone together, we can figure out--on a case-by-case basis--who should and who shouldn't get which treatment. In the long run, we can increase the number of patients and decrease the number who have complications."