True, the desperately awaited results were underwhelming. The results were a classic good-news, bad-news situation, says Walter Block, a professor of biomedical engineering, medical physics, and radiology at University of Wisconsin–Madison, and an expert in magnetic resonance imaging, or MRI. The study concluded that the tested treatment was not ready for normal clinical use in bleeding stroke. 7, evaluated catheter application of clot-busting drugs (which are also used to treat ischemic strokes). Clot removal reduces intracranial pressure and the amount of blood that will eventually break down and damage healthy brain tissue.īut MISTIE, a nation-wide study of clot-busting in 500 hemorrhagic stroke patients, showed that removing much of the clotted blood reduced mortality but did not lead to better brain function or increased independence one year later. Doctors have tried for years to limit further damage by quickly removing as much of the clot as possible – without risking a deadly new bleed. The pool of blood in a hemorrhagic stroke, which can be as large as a tennis ball, damages brain tissue by direct contact, by destroying connections among neurons, and by exerting pressure on surrounding brain tissue. Although only 13 percent of strokes in the United States are hemorrhagic, the American Stroke Association says they cause 40 percent of stroke deaths. Unfortunately, there is no proven treatment for the less common but more deadly hemorrhagic stroke, caused by a bleed in the brain: the “standard of care” is watching, waiting and hoping. But that progress only concerns ischemic strokes, which occur when a clot interferes with blood flow. Stroke treatment has come a long way in the past decade: patients, hurried by the slogan “time is brain,” are visiting stroke centers for injections of clot-busting drugs to prevent brain damage. Seeing the clot structure should enable the physician to deliver a clot-busting drug more precisely. Note that brain swelling and the components of the clot are clearly delineated in MRI. MRI, right, gives much greater detail on a hemorrhagic stroke than CT.
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